Background: In recent years, the treatment of atopic dermatitis (AD) has progressed, and not only topical corticosteroids (TCS) but also anti-inflammatory oral drugs and topical drugs have emerged, and proactive topical therapy has become widely used. However some patients have difficulty in managing skin symptoms under proactive therapy (PT).

Objective: To evaluate the efficacy and safety of Delgocitinib ointment (DEL) in combination with TCS every other day after quenching inflammation in patients with AD inadequately controlled by PT with TCS.

Methods: Fifty-four patients with AD who visited our clinic between January and August 2022 were randomized to two groups: PT with TCS alone or Alternating Proactive Therapy (APAT) with TCS+DEL after resolution of inflammation, and the required endpoints were followed for 12 weeks.

Results: The APAT group had significantly lower EASI scores and a higher rate of achieving EASI-50 at 8 weeks compared to the PT group with TCS alone. NRS and sleep VAS scores were also significantly lower at 8 weeks. The incidence of adverse events did not differ between the two groups.

Conclusion: APAT with TCS+DEL may be more effective than PT with TCS alone for pediatric AD.