EADV Athens 2026: Dupilumab in Pregnancy, Tapering, and Nemolizumab Long-Term Data Reset Atopic Dermatitis Care for Women
The EADV Spring Symposium ran in Athens from May 7 to 9, 2026. On the second morning at 9 a.m. in Trianti Hall, the “What’s New” session on atopic dermatitis became one of the most heated discussions of the meeting. Chaired by Marie-Aleth Richard (France), the session put dupilumab use in pregnancy, tapering after remission, and long-term nemolizumab data on a single agenda — a rewrite of how clinicians manage atopic dermatitis in women of reproductive age.
The most-watched presentation centered on continuing dupilumab during pregnancy. The previous default position for women planning pregnancy was “discontinue when possible.” But accumulated exposure cohorts now tell a different story. Rates of birth defects, miscarriage, and pregnancy complications in women who continued dupilumab through pregnancy were not statistically different from background population rates. The molecular rationale fits: dupilumab is a monoclonal antibody against IL-4 and IL-13 with high molecular weight, and placental transfer of IgG antibodies is limited until later in gestation.
Tapering strategy is another inflection point. For women who reach IGA 0–1 (clear or almost clear) and maintain remission for 6~12 months on dupilumab, three protocols were compared head to head: standard weekly dosing, every-other-week extension, and gradual extension to 4-week intervals. Both extension strategies showed relapse rates around 20~30%, and most relapsing patients re-achieved remission quickly when returned to standard interval. The clinical weight is heaviest for women in their late 30s to 40s, who otherwise face the prospect of weekly injections indefinitely.
Nemolizumab is a newer biologic that blocks the IL-31 receptor alpha, targeting itch signaling itself. The session presented long-term follow-up from ARCADIA 1 and 2: 48–52% achieved EASI-75 at week 16, with 42–45% reaching NRS-4 itch reduction. Efficacy held over longer windows (48 and 96 weeks), and serious adverse event rates matched placebo. Nemolizumab is emerging as an option for patients with inadequate itch control on dupilumab and for those with dupilumab-induced facial erythema.
The updated network meta-analysis covering JAK inhibitors and topicals also dropped. Upadacitinib 30mg and abrocitinib 200mg both produced faster EASI-75 responses than dupilumab. But concerns around herpes zoster reactivation and cardiovascular events kept dupilumab and nemolizumab as the preferred first-line systemic options for women of reproductive age, women planning pregnancy, and patients with relative immunosuppression concerns.
On the lifestyle side, Mette Sondergaard Deleuran (Denmark) covered emollients for barrier restoration, irritant avoidance, and the disease-modifying potential of early intervention. Emollients and probiotics for prevention, and the impact of systemic therapies on skin microbiota, were also addressed. The atopic care paradigm is shifting from symptom suppression toward long-term immune rebalancing.
Adult atopic dermatitis prevalence in Korean women is 5–7%, with rising face and hand involvement in the 30–40 age range. EADV Athens is rewriting the rule that “you have to stop your medication for pregnancy.” Dupilumab continuation through pregnancy, tapering after remission, nemolizumab as a new option — these changes will likely reach Korean dermatology practice within 6~12 months.