Abstract We describe a pediatric patient treated with upadacitinib for atopic dermatitis (AD) who subsequently achieved sustained clinical and histologic remission of eosinophilic esophagitis (EoE). Upadacitinib is an oral small molecule selective Janus kinase 1 inhibitor that inhibits janus kinase‐signal transduction and activation of transcription (JAK‐STAT) pathway with wide inhibitory effects on the immune system, including Th2 signaling pathways. Therefore, it leads to broad suppression of inflammatory cytokines, including interleukin‐4 (IL‐4), interleukin‐13 (IL‐13), and thymic stromal lymphopoietin (TSLP), that play a central role in the pathogenesis of EoE. Given the broad signaling pathway, if a patient is started on upadacitinib for other indications, cessation of other therapies, particularly biologics like dupilumab, should be considered on a case‐by‐case basis.
Nguyen et al. (Fri,) studied this question.