Naslov
Successful baricitinib tapering to 2 mg once daily in a patient with atopic dermatitis and concomitant airborne contact dermatitis

Autori
Dujmović-Hasanbegović, Katarina ; Peternel, Sandra

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
2nd Symposium of the International Contact Dermatitis Research Group - abstract book / - , 2023

Skup
2nd Symposium of the International Contact Dermatitis Research Group

Mjesto i datum
Split, Hrvatska, 31.03.2023. - 02.04.2023

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
atopic dermatitis, baricitinib

Sažetak
Introduction: Baricitinib, an oral selective Janus kinase inhibitor, improves the clinical signs and symptoms of moderate to severe atopic dermatitis (AD) and represents a new treatment option for this indication. Case report: A 62-year-old woman with a history of AD and allergic rhinitis presented with generalized dry eczema, most pronounced on her neck and face areas. She complained of constant itching affecting her sleep. She reported regular worsening of her facial and neck dermatitis in the spring. Severity of disease was evaluated as the Scoring Atopic Dermatitis (SCORAD) index of 60 points and Dermatology Life Quality Index (DLQI) of 14 points. Laboratory analysis showed increased levels of IgE (5497 kU/L), and in vivo tests confirmed hypersensitivity to multiple airborne, food, and contact allergens. Her condition was refractory to conventional treatment with potent topical corticosteroids, methotrexate and multiple courses of prednisolone frequently used as a rescue therapy. Therefore, treatment with baricitinib at a 4 mg daily dose was initiated. This resulted in almost clear and symptom-free skin already at the first follow-up visit at one month from the introduction of baricitinib. At week 12, there was complete remission with SCORAD 3.5 and DLQI 0. This excellent response was maintained throughout the treatment period of 10 months, when we decided to taper the dose of baricitinib. The patient’s skin remained clear and symptomless with 2 mg of baricitinib daily, and only emollients applied topically for additional 4 months. Then, coinciding with more time spent outdoors gardening in mid-February, the patient started to experience signs of dermatitis on her neck, which we believe was triggered by contact with pollen allergens already present in late winter. Although the symptoms were mild, given her previous history of exacerbations in the spring period, we decided to prevent possible further worsening and increased the dose of baricitinib back to 4 mg. Throughout the whole period of treatment (14 months), baricitinib was well tolerated by the patient. Conclusion: This case illustrates that baricitinib shows long-term efficacy in AD and allows taper to 2 mg daily dose. Moreover, in our patient, baricitinib showed high and maintained efficacy also on the signs of concomitant airborne contact dermatitis.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA