Successful response to tralokinumab in patients unresponsive, intolerant or with contraindications to dupilumab and JAK inhibitors: A case series

The recent approval of novel targeted therapies that included two biologics (dupilumab and tralokinumab) and three small molecules consisting of Janus kinase (JAK) inhibitors (abrocitinib, baricitinib and upadacitinib) has profoundly changed the long-term management of moderate-to- severe atopic dermatitis (AD).1,2 Though an optimal control may be obtained, a proportion of patients are unresponsive, intolerant or have contraindications to these therapeutic agents. Tralokinumab has demonstrated a favourable efficacy and safety profile in the treatment of moderate-to- severe AD in both clinical trials and real-life experiences.3–5 However, there is scarce evidence regarding tralokinumab response in difficult-to- treat patients presenting a relevant therapeutic unmet need, being unresponsive, intolerant or presenting contraindications to any available targeted therapy (namely dupilumab and JAK inhibitors).