Targeted Therapy in Children with Atopic Dermatitis
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Tatiana Slavyanskaya, MD PhD, Vladislava Derkach
Rationale: The Development of new strategies of atopic dermatitis (AD) treatment is a topical issue.

Methods: There have been used immunological, allergological and clinical methods.

Results: The determination of the immunopathogenic phenotype (IPF) in 300 children (Ch) 5-17 years with moderately severe AD during exacerbation has made it possible to discover an allergic form of AD with sensibilization to HDMA in 94 Ch (SCORAD 44.2±2.46). It has been noted the prevalence of Th2-cells, phagocytic index/number falls down to 25.5±1.02% and 2.14±0.4 of microbial bodies respectively. Ch have received 3 different complex therapy program (CTP): 1CTP – basic therapy (BT); 2CTP - BT and subcutaneous immunotherapy (SCIT); 3CTP – multiagent immunotherapy – MIT (BT+SCIT+ immunomodulator, aimed at activation of phagocytes). Application of MIT contributed to IFNy synthesis activation and reduction of level of IL-4 and IL-13 cytokines, stimulating specific IgE. The MIT has made it possible to conduct SCIT according to an accelerated schedule, increasing clinical effectiveness as compared 1CTP and 2CTP. In the 3CTP during 3 years, we have recorded a considerable decrease of the SCORAD, reduction of flare-ups, BT in the absence of AD manifestations and hospital care, improvement of quality of life, long-term treatment effect (monitoring exceeding 5 years). MIT was pharmacoeconomically effective.

Conclusions: A preliminary diagnostic of IPF of AD and pathophysiologic disorders, including immune ones, enables a doctor to develop a correct algorithm of combination therapy of AD in Ch, aimed at their correction. A future strategy of treating Ch with AD should be based on application the individual targeted therapy.