Methotrexate and ciclosporin improve skin biomarkers in paediatric atopic dermatitis: results from the TREatment of severe Atopic eczema Trial

Methotrexate (MTX) and ciclosporin (CyA) are the main conventional systemic treatments for severe atopic dermatitis (AD) globally. Despite the emergence of advanced targeted therapies for AD, the complex interaction of cutaneous immune biomarkers and their modulation during systemic therapy remains poorly understood. Our study utilizes the skin cytokine profiles from the TREatment of severe Atopic eczema in children Trial (TREAT) to explore skin immune biomarkers in paediatric patients randomized to either MTX or CyA treatment. Our findings suggest that while both MTX and CyA modulate the cutaneous immune response, MTX has a more pronounced effect on certain immunological and skin barrier biomarkers compared with CyA, even after treatment cessation.