Dupilumab Efficacy and Safety Among Different Ages and Age of Onset of Atopic Dermatitis: Real‐World Experience

Atopic dermatitis (AD) is a chronic cutaneous disorder that may manifest at any age, exhausting healthcare systems. Limited studies investigated patients’ variable responses to targeted therapies, including dupilumab. The present study aimed to investigate dupilumab efficacy and safety in a real‐world setting, correlating them with AD patients’ age and age of onset. This prospective cohort included 44 AD patients (18 pediatric/adolescents and 26 adults) who were candidates for dupilumab therapy. Outcome measures (Eczema Area Severity Index (EASI), Investigator’s Global Assessment (IGA), a numerical rating scale (NRS) for pruritus, and DLQI) were analyzed at baseline and after 4, 16, and 52 weeks of dupilumab therapy. Clear/almost clear skin (IGA 0/1) as well as a higher percentage of improvement was observed in pediatrics/adolescents at Week 16, with no significant difference regarding pruritus control. Among adults, no significant differences were detected in outcome scores regarding age of disease onset. Dupilumab failure was observed more in adults with no significant differences regarding adverse events. Younger age, male gender, early onset, presence of 2 or more atopic comorbidities, and lack of previous immunosuppressant therapy were predictors for improvement. In conclusion, although dupilumab is safe and effective for all AD ages and age‐of‐onset groups, its effectiveness is particularly pronounced in younger pediatric/adolescent patients. Clinicians might prioritize dupilumab for younger immunosuppressant‐naïve patients with early‐onset AD and those with concomitant atopic comorbidities, as they may likely derive the greatest benefit. Careful patient selection will raise drug performance, ensuring the best cost‐effective outcomes.