Discussing International Eczema Council Definitions of Disease Activity, With Raj Chovatiya, MD, PHD

In a recent interview discussing a new consensus framework published in JAMA, Raj Chovatiya, MD, PhD, of Rosalind Franklin University of Medicine and Science, highlighted the growing importance of standardized disease activity definitions in atopic dermatitis and their potential to reshape both clinical care and research.1,2

During his discussion, Chovatiya noted, although there have been recent major therapeutic advances, the dermatology space has lacked clear, universally accepted benchmarks for what would signify the presence of meaningful disease control. As a result, this poses a notable challenge for clinicians, trial investigators, and regulators alike.

“Frankly, you've probably done a number of these interviews over the past couple of years where people use these terms about disease control or disease remission and and there really hasn't been a really standardized approach to defining these concepts,” Chovatiya noted.

Chovatiya spoke about this initiative, headed by the International Eczema Council, as an effort to establish globally relevant definitions for lower levels of disease activity (LDA), for very low disease activity (vLDA), and for disease remission via the use of a structured, consensus-driven process. Drawing on both clinician-reported outcomes, such as Eczema Area and Severity Index (EASI) and validated Investigator Global Assessment (vIGA), and patient-reported measures like itch scores, he noted the framework reflects a more comprehensive view of disease burden.

Chovatiya furthermore pointed to the incorporation of both objective signs and subjective symptoms as being essential, noting pruritus issues and various quality-of-life impacts often impact patient experiences heavily, even when visible inflammation is limited. A key feature of the framework, according to Chovatiya, is its modular structure, which distinguishes between remission of signs, symptoms, and overall disease.

Chovatiya also noted this approach allows for greater nuance in the assessment of treatment response. It also acknowledges complete alignment between clinical findings and patient-reported outcomes as not always occurring. These new definitions also provide invaluable distinctions between on-treatment disease control and sustained remission following cessation of therapy.

Chovatiya described these standardized definitions as potentially allowing for more consistent comparisons across clinical studies and improving regulatory clarity, especially as newer targeted medications continue to raise expectations for treatment outcomes. He also suggested that the framework may support a broader shift toward treat-to-target strategies in atopic dermatitis, helping clinicians to set clearer goals and adjust treatments in a more systematic manner.

Chovatiya previously reported serving as an advisor, consultant, speaker, and/or investigator for AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, Sitryx, and UCB.

References

1. Merola JF, Childs BA, Bartley BR, et al. International Eczema Council Definitions of Low Disease Activity and Remission in Atopic Dermatitis: A Consensus Statement. JAMA Dermatol. Published online April 15, 2026. doi:10.1001/jamadermatol.2026.0662.

2. Smith T. International Eczema Council Releases Definitions of Remission, Low Disease Activity. HCPLive. April 29, 2026. Accessed May 6, 2026. https://www.hcplive.com/view/international-eczema-council-releases-definitions-remission-low-disease-activity.