{"title":"[住院治疗、教育和优化局部治疗可使青少年重度特应性皮炎患者尽早停用口服 jak 抑制剂]。","authors":"Marei Omori, Kiwako Yamamoto-Hanada, Kotaro Umezawa, Seiko Hirai, Daisuke Harama, Kohei Hagino, Yasuaki Matsumoto, Daichi Suzuki, Fumi Ishikawa, Kenji Toyokuni, Tatsuki Fukuie, Yukihiro Ohya","doi":"10.15036/arerugi.73.1168","DOIUrl":null,"url":null,"abstract":"<p><p>In cases of moderate to severe atopic dermatitis that does not respond to topical therapy, temporary systemic administration of molecular targeted drugs (biological agents or oral Janus kinase[JAK]inhibitors) may be necessary. However, topical therapy forms the basis of the treatment for atopic dermatitis, and if topical therapy is appropriately established with long-term remission achieved, the use of molecular targeted drugs can be discontinued. In these two cases of severe adolescent atopic dermatitis, successful initiation of remission was achieved through hospitalization, disease education, skincare guidance, and the combined use of appropriate topical therapy and short-term oral JAK inhibitors during the remission induction phase. Subsequently, maintenance of remission was possible with proactive topical therapy alone. As there are many cases where molecular targeted drugs cannot be discontinued, presenting cases where oral JAK inhibitors were successfully discontinued emphasizes the avoidance of indiscriminate long-term use of molecular targeted drugs. This highlights the significance of topical therapy for atopic dermatitis and the importance of avoiding the careless use of molecular targeted drugs, and supporting the transition to adulthood.</p>","PeriodicalId":35521,"journal":{"name":"Japanese Journal of Allergology","volume":"73 9","pages":"1168-1174"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[HOSPITALIZATION, EDUCATION, AND OPTIMIZATION OF TOPICAL THERAPY CAN LEAD TO THE EARLY DISCONTINUATION OF ORAL JAK INHIBITORS IN ADOLESCENT SEVERE ATOPIC DERMATITIS].\",\"authors\":\"Marei Omori, Kiwako Yamamoto-Hanada, Kotaro Umezawa, Seiko Hirai, Daisuke Harama, Kohei Hagino, Yasuaki Matsumoto, Daichi Suzuki, Fumi Ishikawa, Kenji Toyokuni, Tatsuki Fukuie, Yukihiro Ohya\",\"doi\":\"10.15036/arerugi.73.1168\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In cases of moderate to severe atopic dermatitis that does not respond to topical therapy, temporary systemic administration of molecular targeted drugs (biological agents or oral Janus kinase[JAK]inhibitors) may be necessary. However, topical therapy forms the basis of the treatment for atopic dermatitis, and if topical therapy is appropriately established with long-term remission achieved, the use of molecular targeted drugs can be discontinued. In these two cases of severe adolescent atopic dermatitis, successful initiation of remission was achieved through hospitalization, disease education, skincare guidance, and the combined use of appropriate topical therapy and short-term oral JAK inhibitors during the remission induction phase. Subsequently, maintenance of remission was possible with proactive topical therapy alone. As there are many cases where molecular targeted drugs cannot be discontinued, presenting cases where oral JAK inhibitors were successfully discontinued emphasizes the avoidance of indiscriminate long-term use of molecular targeted drugs. This highlights the significance of topical therapy for atopic dermatitis and the importance of avoiding the careless use of molecular targeted drugs, and supporting the transition to adulthood.</p>\",\"PeriodicalId\":35521,\"journal\":{\"name\":\"Japanese Journal of Allergology\",\"volume\":\"73 9\",\"pages\":\"1168-1174\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Japanese Journal of Allergology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15036/arerugi.73.1168\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Japanese Journal of Allergology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15036/arerugi.73.1168","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
对于局部治疗无效的中度至重度特应性皮炎,可能需要暂时全身使用分子靶向药物(生物制剂或口服 Janus 激酶[JAK]抑制剂)。然而,局部治疗是特应性皮炎治疗的基础,如果局部治疗得到了适当的确立并实现了长期缓解,就可以停止使用分子靶向药物。在这两例严重的青少年特应性皮炎患者中,通过住院治疗、疾病教育、护肤指导,以及在缓解诱导阶段联合使用适当的局部治疗和短期口服 JAK 抑制剂,成功地开始了缓解。随后,仅通过积极的局部治疗就能维持缓解。由于有许多病例不能停用分子靶向药物,因此介绍成功停用口服 JAK 抑制剂的病例强调了避免不加选择地长期使用分子靶向药物的重要性。这凸显了局部治疗特应性皮炎的重要性,以及避免不慎使用分子靶向药物和支持向成人过渡的重要性。
[HOSPITALIZATION, EDUCATION, AND OPTIMIZATION OF TOPICAL THERAPY CAN LEAD TO THE EARLY DISCONTINUATION OF ORAL JAK INHIBITORS IN ADOLESCENT SEVERE ATOPIC DERMATITIS].
In cases of moderate to severe atopic dermatitis that does not respond to topical therapy, temporary systemic administration of molecular targeted drugs (biological agents or oral Janus kinase[JAK]inhibitors) may be necessary. However, topical therapy forms the basis of the treatment for atopic dermatitis, and if topical therapy is appropriately established with long-term remission achieved, the use of molecular targeted drugs can be discontinued. In these two cases of severe adolescent atopic dermatitis, successful initiation of remission was achieved through hospitalization, disease education, skincare guidance, and the combined use of appropriate topical therapy and short-term oral JAK inhibitors during the remission induction phase. Subsequently, maintenance of remission was possible with proactive topical therapy alone. As there are many cases where molecular targeted drugs cannot be discontinued, presenting cases where oral JAK inhibitors were successfully discontinued emphasizes the avoidance of indiscriminate long-term use of molecular targeted drugs. This highlights the significance of topical therapy for atopic dermatitis and the importance of avoiding the careless use of molecular targeted drugs, and supporting the transition to adulthood.
期刊介绍:
The Japanese Society of Allergology is made up of medical researchers and clinical physicians who share an involvement in the study of allergies and clinical immunology. Clinical subspecialties include such allergies and immune-response disorders as bronchial asthma, hypersensitivity pneumonitis, collagen disease, allergic rhinitis, pollenosis, hives, atopic dermatitis, and immunodeficiency. However, there are many patients afflicted by other allergies as well. The Society considers all such patients and disorders within its purview.