Successful use of dupilumab in a patient with severe atopic dermatitis

Atopic dermatitis in children is often severe and resistant to standard topical therapy, especially in the presence of comorbid conditions. Randomized clinical trials of dupilumab targeted therapy for atopic dermatitis may exclude patients with severe comorbidity if, in the opinion of the investigator, this may negatively affect the patient’s participation in the study, and therefore the data on the effectiveness and safety of the drug in this group of patients remain fragmented. This clinical case fills this gap by demonstrating experience using dupilumab in a child with severe atopic dermatitis and concomitant gastrointestinal disease.

An 11-year-old female patient with long-standing severe atopic dermatitis (skin lesion prevalence of 45 % of the body surface area, SCORAD score of 65, pruritus on the visual analog scale of 8 out of 10) and concomitant gastrointestinal pathology. Previous topical therapy with topical glucocorticosteroids and emollients was ineffective. During hospitalization, subcutaneous dupilumab was initiated with a loading dose of 600 mg, followed by 300 mg every 4 weeks. After 12 months of follow-up, remission of atopic dermatitis was achieved. No adverse events requiring drug discontinuation were reported.

This clinical case demonstrates the efficacy and safety of dupilumab in children with severe atopic dermatitis and gastroesophageal reflux disease in combination with eosinophilic esophagitis, dyscholia and functional gallbladder disorder. The therapy allows for simultaneous control of cutaneous and gastrointestinal manifestations, improving the patient’s quality of life.