Abstract
Dupilumab, the first biologic treatment approved for moderate to severe atopic dermatitis, has completely revolutionized the management of such disease allowing long-term control of its clinical signs and symptoms. Nevertheless, data regarding the safety and effectiveness profile of dupilumab in patients belonging to special populations are scarce. This observational, multicentric study analysed the effectiveness and safety profile of dupilumab over 3 years in the treatment of 70 patients with moderate to severe atopic dermatitis and associated comorbidities such as cancers, renal and liver failure, viral chronic infections, and degenerative and autoimmune neurological disorders. Patients achieved a significant improvement in both physician-assessed and patient-reported outcomes after 16 weeks of treatment, with a continuous therapeutic response maintained throughout the 156-week period. The safety profile was comparable to clinical trials and real-world data involving patients without significant comorbidities. In conclusion, the findings support the safety of dupilumab in managing severe atopic dermatitis in fragile patients.