dupilumab + tacrolimus

Dupilumab + tacrolimus is a combination therapy used primarily for treating atopic dermatitis, especially facial manifestations. Dupilumab is a monoclonal antibody that inhibits IL-4 and IL-13 signaling by binding to the IL-4Rα subunit, blocking both IL-4 signaling via the Type I receptor and IL-4/IL-13 signaling through the Type II receptor. This inhibition reduces Th2-mediated inflammation, improves skin barrier function, and alleviates symptoms. Tacrolimus is a topical calcineurin inhibitor that binds to FKBP-12 and inhibits calcineurin, preventing T-cell activation and blocking the transcription of inflammatory cytokines. The combination has demonstrated enhanced efficacy compared to either agent alone, particularly for facial atopic dermatitis, with studies showing rapid improvement in symptoms and quality of life without significant increases in adverse reactions.