Real-World Relapse Rate After Biologic Withdrawal in Atopic Dermatitis 真实世界中生物制剂停药后特应性皮炎复发率

Across heterogeneous cohorts, the first six months are decisive:

* In population-level registries, only ≈ 1 in 4 dupilumab patients and < 1 in 10 JAK1-inhibitor patients remain flare-free at one year.

* Median drug-free remissions cluster around 8–10 months for dupilumab but < 1 month for upadacitinib when treatment is halted abruptly.

* Small “deep-remission” series show that carefully selected patients can enjoy ~9-month remissions; however, these constitute the minority and suffer from selection bias.

Dupilumab provides the best odds (≈ 25 % one-year remission), whereas JAK1 inhibitors relapse within weeks. Until predictive biomarkers emerge, permanent maintenance or dose-spacing strategies trump full cessation.

综合多项研究，停药后前 6 个月为复发高危期：

* 大型注册研究显示：仅约 25 % 的 dupilumab 患者、不足 10 % 的 JAK1 抑制剂患者在停药 1 年后仍无复发。

* 停生物制剂后的中位无病期约为 dupilumab 8–10 个月，而 upadacitinib < 1 个月。

* 严格遴选的“小样本深度缓解”病例可获得 约 9 个月 的无病期，但存在明显选择偏倚。

Dupilumab （Dupixent) 的一年无病率约 25 %，JAK1 抑制剂数周即复发。在缺乏可预测生物标志物前，维持治疗或延长给药间隔优于完全停药。

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Reference

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