Toward a Multidimensional Framework for Defining Remission in Atopic Dermatitis

Abstract: Defining remission in atopic dermatitis (AD) remains challenging due to heterogeneous criteria and inconsistent endpoints. Current approaches often conflate good disease control with true remission, and few integrate multidomain assessments. This review proposes a functional spectrum of treatment response, ranging from nonresponse to complete treatment-free remission, incorporating both duration and treatment context. The framework distinguishes complete control on therapy, durable control over extended periods, response maintained after dose tapering, and sustained improvement following treatment cessation. Clinical, patient-reported, and immunological dimensions are considered, with emphasis on practical applicability to trial design. Opportunities for innovation include wearable technology, patient-reported digital tools, and predictive analytics to capture real-time disease dynamics and identify candidates for deep remission. By adopting standardized definitions and composite endpoints informed by disease biology and patient experience, future trials can more accurately measure meaningful, durable outcomes. Standardized remission criteria will improve cross-study comparability, guide therapeutic development, and align clinical care with the goal of long-term, treatment-free disease control in AD.