Evidence map›Paper›PMID 41204825›Full record

ArticleJournal of the European Academy of Dermatology and Venereology : JEADV2026

The SWITCH algorithm: An expert consensus on treat-to-target criteria for chronic prurigo.

Lea S Stahl, Claudia Zeidler, Joyce Loewenthal, Svenja Royeck, Matthias Augustin, Robert Bissonnette, Sarina Elmariah, Brian S Kim, Laurent Misery, Hiroyuki Murota and 7 more

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the European Academy of Dermatology and Venereology : JEADV, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Advances in chronic Prurigo: From terminology to a new treatment algorithm.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Article
  2. The SWITCH algorithm: An expert consensus on treat-to-target criteria for chronic prurigo.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Article
  3. Review
  4. [Biologics and infections: understand and recognize].Dermatologie (Heidelberg, Germany) · 2026
    Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Lea S StahlSection Pruritus Medicine, Department of Dermatology, and Center of Chronic Pruritus, University Hospital Münster, Münster, Germany.ORCID https://orcid.org/0009-0008-1886-1294
Claudia ZeidlerSection Pruritus Medicine, Department of Dermatology, and Center of Chronic Pruritus, University Hospital Münster, Münster, Germany.ORCID https://orcid.org/0000-0002-9485-8627
Joyce LoewenthalSection Pruritus Medicine, Department of Dermatology, and Center of Chronic Pruritus, University Hospital Münster, Münster, Germany.ORCID https://orcid.org/0009-0008-6247-8997
Svenja RoyeckSection Pruritus Medicine, Department of Dermatology, and Center of Chronic Pruritus, University Hospital Münster, Münster, Germany.ORCID https://orcid.org/0000-0002-2118-959X
Matthias AugustinCompetence Center of Healthcare Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID https://orcid.org/0000-0002-4026-8728
Robert BissonnetteInnovaderm Research, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0001-5927-6587
Sarina ElmariahDepartment of Dermatology, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-1352-5020
Brian S KimDepartment of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID https://orcid.org/0000-0002-8100-7161
Laurent MiseryLaboratoire Interactions Neurones-Keratinocytes (LINK), University of Brest, Brest, France.ORCID https://orcid.org/0000-0001-8088-7059
Hiroyuki MurotaDepartment of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.ORCID https://orcid.org/0000-0002-0450-1377
Hong Liang TeyDepartment of Dermatology, National Skin Center, Singapore, Singapore.ORCID https://orcid.org/0000-0001-8894-6711
Elke WeisshaarDivision of Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0002-7016-0224
Gil YosipovitchMiami Itch Center, Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA.ORCID https://orcid.org/0000-0001-6303-1822
Franz J LegatDepartment of Dermatology and Venereology, Medical University of Graz, Graz, Austria.ORCID https://orcid.org/0000-0002-7785-4739
Adam ReichDepartment of Dermatology, University of Rzeszów, Rzeszów, Poland.ORCID https://orcid.org/0000-0002-5573-1754
Martin MetzInstitute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-4070-9976
Sonja StänderSection Pruritus Medicine, Department of Dermatology, and Center of Chronic Pruritus, University Hospital Münster, Münster, Germany.ORCID https://orcid.org/0000-0003-3612-7786

Funding

Deutsche Forschungsgemeinschaft FOR 2690Deutsche Forschungsgemeinschaft FOR 5211Galderma
6 · The paper itself

Abstract

backgroundTo date, the management of chronic prurigo (CPG; prurigo nodularis) relies on expert consensus and guidelines without providing detailed recommendations on long-term treatment management.

objectivesThis study was initiated by an expert committee to define, validate and reach consensus on treat-to-target (T2T) criteria and a decision-supporting treatment algorithm for CPG.

methodsA prospective, single-centre, non-interventional study was conducted in adult CPG patients at a moderate-to-severe disease stage, experiencing intense itch (NRS ≥7; Group A), and in patients who considered themselves successfully treated (Group B). The patients answered questions about their most severe symptoms and essential therapy goals. A committee of 14 field experts evaluated the study results, identified outcome tools from clinical trials and defined and weighted T2T criteria. Based on this, a treatment algorithm was developed through an iterative consensus-building method and anonymous voting.

results171 patients (Group A, n = 96; Group B, n = 75) were interviewed. Itch (99.4%), the need to scratch (48%), and pruriginous lesions (45.6%) were the most frequently reported severe symptoms. Pruritus relief (over complete pruritus resolution) and healing of lesions were the key therapeutic goals. In clinical trials, the most frequently used instruments were assessments of worst/peak itch intensity, disease severity via IGA, DLQI and sleep quality. According to the results, the experts defined initial itch control as NRS ≤3, lesion healing with IGA-S 0/1, and burden, along with their respective clinically measurable parameters, as T2T criteria. These criteria, with predefined cut-off values, serve as the decision-tree keys that constitute the treatment algorithm presented here, facilitating a decision to maintain or switch the treatment.

conclusionsThe T2T criteria and the SWITCH treatment algorithm offer a valid and systematic method for evaluating and refining CPG treatment based on patient-reported and expert-validated data. This will help to improve the treatment of patients with CPG.

Indexed as

AlgorithmsPrurigoAdultAgedChronic DiseaseFemaleHumansMaleMiddle AgedProspective StudiesPruritusSeverity of Illness Indexchronic prurigochronic pruritusitchprurigo nodularistreatment algorithmtreat‐to‐target

Identifiers

PMID41204825
PMCPMC13308662

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.