Efficacy and Safety of Dupilumab in Treating Intrinsic and Extrinsic Atopic Dermatitis in Older Patients With and Without Atopic Comorbidities: A Retrospective Study

Background: Despite the widespread use of dupilumab in atopic dermatitis (AD) treatment, evidence supporting its use in older patients with intrinsic AD (IAD) versus those with extrinsic AD (EAD) and in those with and without atopic comorbidities remains limited. Objective: We aimed to assess the clinical efficacy and safety of dupilumab treatment in elderly patients with IAD versus EAD and in those with and without atopic comorbidities. Methods: We enrolled 113 older patients with severe AD who received dupilumab for 48 weeks. The inclusion criteria were age ≥60 years and Scoring Atopic Dermatitis ≥25. Patients were classified as IAD or EAD and based on the presence of atopic comorbidities. The primary outcome was a reduction in the Eczema Area and Severity Index, Numeric Rating Scale, Dermatology Life Quality Index, and Atopic Dermatitis Control Test. Secondary measures were the types and rates of adverse events. Results: Dupilumab treatment resulted in a substantial improvement in AD symptoms, with no significant difference between patients with IAD and EAD or those with and without atopic comorbidities. Conclusions: Dupilumab showed good efficacy and safety in improving AD symptoms in older patients, irrespective of IAD or EAD subtypes and the presence of atopic comorbidities.