When One Target Isn’t Enough — Dual Therapy Clears Refractory ADW
An adolescent with persistent, widespread atopic dermatitis failed topical therapy and dupilumab, then achieved only partial control on upadacitinib 30 mg before flaring. Adding lebrikizumab (500 mg loading at weeks 0 and 2, then 250 mg q2w) while continuing upadacitinib led to marked and sustained clearance.
This case is notable because the biologic was added to an active JAK inhibitor (rather than the more common scenario of JAK rescue after biologic failure) and it suggests that carefully selected dual targeted therapy can work where monotherapy does not. It’s a single‑patient signal, not a practice‑changing trial, but it raises practical questions about patient selection, safety monitoring, and when to consider combination biologic plus small‑molecule therapy.
Want the treatment timeline, explore the photos, and the authors’ approach to risk assessment and monitoring? Read the full report to see how this strategy might fit into complex AD care.
J Drugs Dermatol. 2025;24(10) doi:10.36849/JDD.9336
Blog write-up assisted by AI
