A single center real-world study of Dupilumab in the treatment of moderate to severe atopic dermatitis in elderly patients

The clinical efficacy and safety of Dupilumab in the treatment of moderate-to-severe atopic dermatitis (AD) in elderly patients, particularly those over 60 years of age, remains an area requiring further investigation. To address this gap, we conducted a 16-week, single-center, prospective, open-label study at Huashan Hospital affiliated with Fudan University. A total of 110 elderly patients with moderate-to-severe AD were enrolled and received Dupilumab treatment. The primary objective was to evaluate the clinical response and safety profile of Dupilumab in this specific age group under real-world conditions.Patients were systematically assessed at multiple time points: baseline (week 0), week 2, week 4, week 8, week 12, and week 16. Key clinical indicators included the Eczema Area and Severity Index (EASI), the Itching Numerical Rating Scale (NRS), the Dermatology Life Quality Index (DLQI), and the Investigator’s Global Assessment (IGA) score. We also calculated the proportion of patients achieving EASI-50, EASI-75, and EASI-90, representing improvements of 50%, 75%, and 90% from baseline, respectively. In addition, laboratory parameters such as serum total IgE levels and blood eosinophil counts were measured at weeks 0, 4, and 16 to evaluate changes in biomarkers associated with AD. All adverse events occurring during the treatment period were documented to assess safety.Among the 110 participants, 78 (70.9%) were male and 32 (29.1%) were female, with a mean age of 72.42±11.64 years. The results demonstrated that Dupilumab led to early and sustained improvements across all efficacy endpoints. By week 16, a significant majority of patients had achieved meaningful clinical responses: 83.36% attained EASI-50, 71.82% reached EASI-75, and half of the study population (50.91%) achieved EASI-90. Moreover, 69.09% of patients attained an IGA score of 0 or 1, indicating clear or almost clear skin. Laboratory findings further supported the clinical benefits, with statistically significant reductions in both serum total IgE and eosinophil counts by week 16 compared to baseline in patients who had elevated levels initially.Regarding safety, Dupilumab was well-tolerated in the elderly cohort. Adverse events were reported in 13 patients (11.8%), the most common being injection site pain (7 cases, 6.4%) and ocular discomfort, such as conjunctivitis or dry eyes (4 cases, 3.6%). Most adverse events were mild to moderate in severity.In conclusion, this real-world study indicates that Dupilumab offers favorable efficacy and an acceptable safety profile for the treatment of moderate-to-severe atopic dermatitis in elderly Chinese patients. These findings support its use in this growing patient population, although longer-term observational studies are warranted to further confirm its sustained benefits and safety.