Managing Atopic Dermatitis with Dupilumab in Special Populations: A Case Series Study

Ersilia Tolino,1 Nevena Skroza,1 Antonio Di Guardo,2,3 Ilaria Proietti,1 Nicoletta Bernardini,1 Concetta Potenza1 1Unit of Dermatology, Department of Medical-Surgical Science and Biotechnologies, Sapienza University of Rome, A. Fiorini Hospital, Terracina, Latina, Italy; 2Department of Medical and Cardiovascular Sciences, “Sapienza” University of Rome, Rome, Italy; 3IDI-IRCCS, Dermatological Research Hospital, Rome, ItalyCorrespondence: Antonio Di Guardo, Department of Medical and Cardiovascular Sciences, “Sapienza” University of Rome, Rome, Italy, Tel +393341513025, Email [email protected]: Atopic dermatitis (AD) is a chronic inflammatory skin disorder with skin barrier disruptions and heightened T helper (Th) 2-mediated inflammation. Dupilumab, a monoclonal antibody targeting interleukin-4 and − 13 pathways, has shown efficacy in treating AD and other type 2 inflammatory diseases. However, its safety and effectiveness in special populations (SP) like kidney transplant recipients, cancer patients, and individuals with neurological conditions remain unclear.Materials and Methods: This retrospective case series includes 12 representative cases of SP treated with dupilumab, featuring cases of a kidney transplant recipient, a metastatic melanoma patient, a non-functioning pituitary adenoma patient, and an individual with multiple sclerosis (MS). Clinical data were collected, and outcomes were assessed using various indices.Results: Dupilumab provided significant AD symptom improvement across all cases, with no adverse effects or recurrence of underlying conditions.Conclusion: Dupilumab shows promise for managing AD in SP, but careful monitoring and further research are necessary to address safety concerns and optimize treatment strategies. Larger studies with longer follow-ups are needed to fully evaluate its safety and efficacy in SP and those with comorbidities. These findings support the need for personalized treatments and ongoing research to enhance outcomes in patients with complex medical histories.Keywords: atopic dermatitis, dupilumab, special populations, melanoma, kidney transplant, multiple sclerosis