Objective. Development of a comprehensive algorithm for the therapy and prevention of exacerbations of atopic dermatitis (AD) in children with moderate and severe forms of the disease, based on the Eczema Area and Severity Index (EASI) and SCORing Atopic Dermatitis (SCORAD) index.
Methods. To assess the severity of atopic dermatitis, and subsequently the effectiveness of the therapy, patients were divided into three groups of 40 patients, in whom the EASI, SCORAD, DLQI, IGA, NRS, POEM indices were studied, laboratory tests were carried out (clinical urine analysis, clinical blood test, biochemical blood test, total IgE level) at 16, 28, 52, 64, 104 weeks of follow-up. During this follow-up period, adverse events were also assessed.
Results. As a result of the assessment of the EASI and SCORAD indices, their complex indicators indicate positive statistically significant (p<0.001) dynamics of the pathological process by 16 and 28 weeks with further stabilization of the indicators in the subsequent follow-up period. Moreover, starting from the 52nd week of follow-up, the program DUP + TGCS + TCI + EMOL (Group 2) demonstrated the greatest efficiency, the program DUP + TGCS + EMOL (Group 1) was in second place in terms of efficiency, and the program DUP + EMOL (Group 3) showed the least efficiency. Conclusion. According to comparative assessment of the safety and clinical efficiency of various complex algorithms for the treatment of children with moderate and severe AD who received an IL-4, IL-13 inhibitor (dupilumab), depending on the method of topical therapy, in the aspect of a 2-year follow-up based on the data of the EASI and SCORAD indices, it is possible to present the algorithm «TGCS 1 time per day – 2 weeks, then TCI 2 times per day up to 16 weeks, then TCI 2 times per week + emollients up to 104 weeks» as the most effective method of safe proactive therapy and prevention of exacerbations of AD in childhood, with a recommendation for its further implementation in the practice of dermatovenereological and pediatric departments, hospitals and clinics.

Keywords: topical calcineurin inhibitor, SCORAD, EASI, dupilumab, methylprednisolone aceponate, emollients, atopic dermatitis, combination therapy, children