Christodoulides, P., Hirata, Y., Dominguez-Huttinger, E. et al. (5 more authors) (2017) Computational design of treatment strategies for proactive therapy on atopic dermatitis using optimal control theory. Philosophical Transactions A. Mathematical, Physical and Engineering Sciences, 836. 88. ISSN 1364-503X
Abstract
Atopic dermatitis (AD) is a common chronic skin disease characterised by recurrent skin inflammation and weak skin barrier, and is known to be a precursor to other allergic diseases such as asthma. AD affects up to 25% of children worldwide and the incidence continues to rise. There is still uncertainty about the optimal treatment strategy in terms of choice of treatment, potency, duration and frequency. This study aims to develop a computational method to design optimal treatment strategies for the clinically recommended "proactive therapy" for AD. Proactive therapy aims to prevent recurrent flares once the disease has been brought under initial control. Typically this is done by using an anti-inflammatory treatment such as a potent topical corticosteroid intensively for a few weeks to "get control", followed by intermittent weekly treatment to suppress subclinical inflammation to "keep control". Using a hybrid mathematical model of AD pathogenesis that we recently proposed, we computationally derived the optimal treatment strategies for individual virtual patient cohorts, by recursively solving optimal control problems using a differential evolution algorithm. Our simulation results suggest that such an approach can inform the design of optimal individualised treatment schedules that include application of topical corticosteroids and emollients, based on the disease status of patients observed on their weekly hospital visits. We demonstrate the potential and the gaps of our approach to be applied to clinical settings.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited. |
Keywords: | atopic dermatitis; treatment schedule; mathematical model; personalized treatment; optimal control theory; differential evolution |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > Department of Infection, Immunity and Cardiovascular Disease The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 01 Jun 2017 15:53 |
Last Modified: | 01 Jun 2017 15:53 |
Published Version: | https://doi.org/10.1098/rsta.2016.0285 |
Status: | Published |
Publisher: | The Royal Society |
Refereed: | Yes |
Identification Number: | 10.1098/rsta.2016.0285 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:117074 |