Work

Add-on treatments in patients with atopic dermatitis with incomplete response to biologic agents or systemic Janus kinase inhibitors: a review

Year: 2026

Type: article

Abstract: Atopic dermatitis (AD) is a chronic inflammatory skin condition with a substantial impact on quality of life. It is challenging to control with traditional therapies. The introduction of biologic agents and systemic Janus kinase inhibitors (JAKis) has improved therapeutic outcomes; however, many patients exhibit incomplete responses to these agents. Add-on strategies include traditional systemic drugs or phototherapy added to biologic agents or JAKis to enhance treatment outcomes. However, their use in these subsets of patients is underexplored. To assess these approaches, the authors conducted a literature review focused on add-on treatments in cases of moderate-to-severe AD with incomplete responses to biologics or JAKis. Relevant studies were identified and examined, with particular attention to changes in clinical outcomes and adverse event profiles. Data limitations included variability in study designs and outcome measures. The results consistently show that add-on therapies achieve larger reductions in validated clinical scores (e.g. Eczema Area and Severity Index; EASI) and higher responder rates (e.g. ≥ 75% improvement in EASI) than monotherapy. The use of traditional systemic agents as add-on treatment, even for a short period, can enhance partial responses to biologic agents or JAKis, leading to more effective disease control. Also, emerging data suggest that combining biologics with JAKis or vice versa may benefit patients who do not achieve adequate relief from either as monotherapy. While these findings are encouraging, several issues remain, among these the lack of large studies, the optimal timing, the cost-effectiveness, the long-term safety and the real-world feasibility. Further well-designed clinical trials are needed to establish standardized add-on regimens, guiding clinicians towards personalized AD treatment.

Source: Clinical and Experimental Dermatology

DOI: 10.1093/ced/llag062

Authors: Aldo Lajos Di Marco, Giulia Vinci, Giuseppe Micali, Maria L Musumeci

Institution: University of Catania

Language: English

Topic: Dermatology and Skin Diseases

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,354