ArticleFrontiers in immunology2026
Efficacy and safety of dupilumab following discontinuation of JAK inhibitors in patients with moderate-to-severe atopic dermatitis: a single-center retrospective study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Switching systemic therapies is common in atopic dermatitis (AD). Current reports focus mainly on switching from dupilumab to janus kinase inhibitors (JAKi), with limited data on transitioning from JAKi to dupilumab. Objective: To explore the feasibility of dupilumab as maintenance or replacement therapy following JAKi discontinuation in moderate-to-severe AD. Methods: This single-center retrospective study enrolled patients with moderate-to-severe AD between June 2023 and January 2026 who initially received JAKi and replaced with dupilumab. Clinical scores (EASI, PP-NRS, DLQI, and ADCT) were analyzed at baseline, JAKi discontinuation, dupilumab initiation, and week 16. Safety events were recorded. Results: Fifteen patients aged 17-81 years (41.93 ± 20.90) were included. At the time of JAKi discontinuation, 10 patients (66.67%) achieved EASI-75. Nine patients switched immediately to dupilumab, and 6 switched after 2-20 weeks. After 16 weeks of dupilumab treatment, 14 patients (93.33%) demonstrated clinical benefit (achieved EASI-50, PP-NRS ≤ 4, DLQI ≤ 5, and ADCT < 7), of whom 11 (73.33%) achieved EASI-75. Among the 9 immediate-switch patients, 4 experienced recurrence within the first 4 weeks; 3 stabilized with short-term conventional therapy, and 1 resumed upadacitinib after 8 weeks. Adverse events were reported more frequently with JAKi (7/15, 46.67%) than with dupilumab (0/15, 0.00%); no serious adverse events were observed. Conclusion: Dupilumab may be a potential maintenance or alternative treatment option for moderate-to-severe AD patients who require discontinuation of JAKi therapy. Disease fluctuations after direct switching warrant attention, and larger prospective studies are needed to validate switching strategies.
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