Department of Pediatrics, Renji Hospital affiliated to ShangHai JiaoTong University School of Medicine, Shanghai, China.
Department of Pediatrics, Renji Hospital affiliated to ShangHai JiaoTong University School of Medicine, Shanghai, China;
Allergol Immunopathol (Madr). 2023 Mar 1;51(2):184-190. doi: 10.15586/aei.v51i2.778. eCollection 2023.
Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that manifests in skin dryness, severe itching, and eczema, and can significantly impact a patient's quality of life. Current treatment regimens do not prevent the recurrence of the disease and are associated with adverse effects. Here, we report two cases of moderate-to-severe AD in children that were treated with dupilumab, a dual inhibitor of IL-4 and IL-13 signaling, in combination with mite allergen-specific immunotherapy.
Both patients presented with the diagnosis of AD that was not adequately controlled by the conventional treatment regimen, including topical corticosteroids (TCS), topical calcineurin inhibitors, emollients, and the traditional Chinese medicine treatments. In both patients, AD-associated skin irritation impacted the quality of life, disturbed sleep patterns, and caused stress and anxiety.Patients received treatment with dupilumab and mite allergen-specific immunotherapy in addition to the baseline treatment regimen of external glucocorticoids (TCS) and oral antihistamines. Nine months after beginning of treatment, clinical symptoms, signs, medication scores, and evaluation scale scores of both children significantly improved, and the treatment was associated with an overall good tolerance.
A combination of dupilumab and mite allergen-specific immunotherapy in addition to the standard anti-AD treatment improves clinical symptoms and is not associated with increased incidence of adverse effects.
特应性皮炎（AD）是一种慢性、复发性炎症性皮肤病，表现为皮肤干燥、剧烈瘙痒和湿疹，可显著影响患者的生活质量。目前的治疗方案无法预防疾病的复发，并且与不良反应相关。在这里，我们报告了两例中重度 AD 患儿，他们接受了 IL-4 和 IL-13 信号双重抑制剂度普利尤单抗联合螨变应原特异性免疫治疗。
两名患者均被诊断为 AD，常规治疗方案（包括外用皮质类固醇、外用钙调磷酸酶抑制剂、保湿剂和中药治疗）无法有效控制。AD 相关的皮肤刺激影响了两名患者的生活质量、睡眠模式，并导致压力和焦虑。在基线治疗方案（外用皮质类固醇和口服抗组胺药）的基础上，患者还接受了度普利尤单抗和螨变应原特异性免疫治疗。治疗 9 个月后，两名患儿的临床症状、体征、药物评分和评估量表评分均显著改善，且治疗总体耐受良好。
在标准抗 AD 治疗的基础上联合使用度普利尤单抗和螨变应原特异性免疫治疗可改善临床症状，且不增加不良反应发生率。
