Older Patients with Atopic Dermatitis Show More Pronounced Early Clinical Improvement with Tralokinumab: A Single-Center Retrospective Real-World Study

<b>Background/Objective</b>: Tralokinumab, a monoclonal antibody targeting interleukin-13, is an effective treatment for atopic dermatitis (AD). However, real-world data on age-related differences in clinical responses, particularly among older patients, remain limited. We compared early improvements in pruritus and skin lesions, as well as effectiveness, safety, and treatment persistence of tralokinumab, between older patients aged ≥ 70 and <70 years in real-world clinical practice. <b>Methods</b>: This single-center retrospective study included 43 patients with AD who initiated tralokinumab. Patients who discontinued treatment within 3 months, lacked a 3-month evaluation, or had a baseline Eczema Area and Severity Index (EASI) score < 16 were excluded, leaving 33 patients for effectiveness analyses. Patients were stratified by age (≥70 vs. <70 years). Outcomes at 3 months included pruritus severity assessed by the Peak Pruritus Numerical Rating Scale (PP-NRS), eczema severity assessed by the EASI, and response rates (PP-NRS4 and EASI75). Adverse events and reasons for treatment discontinuation were evaluated in all patients. <b>Results</b>: At 3 months, both age groups showed improvement in pruritus and skin lesions. Patients aged ≥ 70 years demonstrated more pronounced early improvement, with a median PP-NRS of 1 (interquartile range, 0-3), a PP-NRS4 response rate of 89.5%, and an EASI75 response rate of 84.2%. Treatment continuation rates did not differ significantly between age groups, indicating comparable tolerability. <b>Conclusions</b>: Tralokinumab was effective and well tolerated in both age groups, with older patients experiencing earlier and more pronounced clinical improvement. These findings suggest that tralokinumab may be effective in elderly patients with atopic dermatitis. These results may suggest tralokinumab as an effective therapy for elderly patients with atopic dermatitis. Validation using larger prospective studies is needed.