Upadacitinib-Methotrexate Combination Therapy for Refractory Atopic Dermatitis: A Case Series of a Novel Therapeutic Approach

We report a single-centre case series of four adults with severe, treatment-refractory atopic dermatitis treated with combined upadacitinib and methotrexate. All patients had failed multiple prior systemic therapies, and while upadacitinib induced initial improvement, addition of methotrexate led to further disease control. Following combination therapy, all achieved EASI-75 or greater, including three patients attaining EASI-90/100 with marked improvements in quality of life.