Reaching for the Stars in Atopic Dermatitis: Efficacy, Safety, Tolerability, Accessibility, and Remission/Remittive Effects (ESTAR)

Atopic dermatitis (AD), a chronic inflammatory skin condition affecting up to 20% of children and 7% of adults in the United States, significantly impacts quality of life through recurrent flares and persistent symptoms. This commentary introduces the ESTAR framework-Efficacy, Safety, Tolerability, Accessibility, and Remission/Remittive Effects-as a modernized tool for shared decision-making in AD management. By addressing critical factors such as efficacy (onset speed, depth, durability, and reliability), safety, tolerability, and remission potential, this framework can aid in evaluating emerging therapies with a patient-centered approach. The ESTAR framework emphasizes balancing immediate symptom relief with sustainable long-term disease control, offering tools such as a radar chart to help clinicians and patients navigate complex treatment options, improve adherence, and optimize outcomes in AD care.