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Case Reports
. 2025 Mar-Apr;42(2):358-363.
doi: 10.1111/pde.15761. Epub 2024 Oct 3.

A Case Series of Refractory Pediatric Atopic Dermatitis Effectively Treated With Dupilumab in Combination With Abrocitinib

Wei Chern Gavin Fong  1 , Htet Hla Win Kaung  2 , Rhea Lopes  3   4 , Alpa Kanji  3   4   5 , Jane Ravenscroft  1   2 , Ting Seng Tang  1   2 , Carsten Flohr  3   4   5
Affiliations
Case Reports

A Case Series of Refractory Pediatric Atopic Dermatitis Effectively Treated With Dupilumab in Combination With Abrocitinib

Wei Chern Gavin Fong et al. Pediatr Dermatol. 2025 Mar-Apr.

Abstract

Children with severe atopic dermatitis (AD), refractory to conventional systemic treatment as well as single-agent biologic and Janus kinase inhibitor (JAKi) such as abrocitinib, currently face a lack of treatment options. In response to this clinical conundrum, we present three cases of severe and refractory pediatric AD successfully managed with combined dupilumab and abrocitinib. These children had exhausted all conventional treatments and had undergone treatment with both dupilumab and abrocitinib individually, as well as dupilumab in conjunction with methotrexate. It was only when the combination of dupilumab and abrocitinib was introduced that they finally achieved noticeable and sustained improvements in disease control.

Keywords: Janus kinase inhibitors; atopic dermatitis; biologics; dupilumab; eczema.

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Conflict of interest statement

C.F. is Chief Investigator of the UK‐Irish Atopic eczema Systemic Therapy Register (A‐STAR; ISRCTN11210918) and a Principle Investigator in the European Union (EU) Horizon 2020‐funded BIOMAP Consortium (http://www.biomap‐imi.eu/). He also leads the EU Trans‐Foods consortium and is Director of the Global Atopic Dermatitis Atlas (GADA). His department has received funding from Sanofi‐Genzyme and Pfizer for skin microbiome work. He has also received compensation from the British Journal of Dermatology (Reviewer and Section Editor) and EuroGuiDerm (Guidelines Lead). W.C.G.F. owns stocks in Sanofi, GSK, and AstraZeneca. All other authors report no relevant conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Timelines of treatment for the three cases. (a) Timeline of treatment for Case 1. (b) Timeline of treatment for Case 2. (c) Timeline of treatment for Case 3.
FIGURE 2
FIGURE 2
Images of Patient 1 before biologic therapy.
FIGURE 3
FIGURE 3
Images of Patient 1 after being established on dupilumab. Please see Figure 1a timeline for corresponding time point.
FIGURE 4
FIGURE 4
Images of Patient 1 illustrating poorly controlled eczema being on dupilumab monotherapy, following a unsuccessful trial on abrocitinib. Please see Figure 1a timeline for corresponding time point.
FIGURE 5
FIGURE 5
Images of Patient 1 after being established on combination therapy with dupilumab and abrocitinib. Please see Figure 1a timeline for corresponding time point.
See this image and copyright information in PMC

References

    1. McKenna S. P. and Doward L. C., “Quality of Life of Children With Atopic Dermatitis and Their Families,” Current Opinion in Allergy and Clinical Immunology 8, no. 3 (2008): 228–231, 10.1097/ACI.0b013e3282ffd6cc. - DOI - PubMed
    1. Halling A. S., Loft N., Silverberg J. I., Guttman‐Yassky E., and Thyssen J. P., “Real‐World Evidence of Dupilumab Efficacy and Risk of Adverse Events: A Systematic Review and Meta‐Analysis,” Journal of the American Academy of Dermatology 84, no. 1 (2021): 139–147, 10.1016/j.jaad.2020.08.051. - DOI - PubMed
    1. Drucker A. M., Morra D. E., Prieto‐Merino D., et al., “Systemic Immunomodulatory Treatments for Atopic Dermatitis: Update of a Living Systematic Review and Network Meta‐Analysis,” JAMA Dermatology 158, no. 5 (2022): 523–532, 10.1001/jamadermatol.2022.0455. - DOI - PMC - PubMed
    1. Chovatiya R. and Paller A. S., “JAK Inhibitors in the Treatment of Atopic Dermatitis,” Journal of Allergy and Clinical Immunology 148, no. 4 (2021): 927–940, 10.1016/j.jaci.2021.08.009. - DOI - PMC - PubMed
    1. Klein B., Treudler R., and Simon J. C., “JAK‐Inhibitors in Dermatology – Small Molecules, Big Impact? Overview of the Mechanism of Action, Previous Study Results and Potential Adverse Effects,” Journal der Deutschen Dermatologischen Gesellschaft 20, no. 1 (2022): 19–24, 10.1111/ddg.14668. - DOI - PubMed

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