Table 1_Efficacy and safety of dupilumab in moderate-to-severe atopic dermatitis with stage 3–5 chronic kidney disease: a retrospective real-world study.docx

CFS score decreased by 17.5%. Eosinophil counts decreased by 25.0%, while IL-10 and Treg proportions increased by 49.9% and 50.8%, respectively. At week 24, EASI-50, EASI-75, and EASI-90 response rates were 100%, 76.9%, and 7.7%, respectively; 100% of patients achieved ≥4-point improvements in both pruritus NRS and DLQI.

IL-10 and Treg continued to rise, and CFS score was significantly reduced from baseline (P = 0.001). Renal function parameters remained stable throughout the 24-week follow-up: mean eGFR showed a minimal decline from 37.93 ± 14.88 to 36.39 ± 14.77 mL/min/1.73 m² at week 24 (P = 0.073), serum creatinine and UPCR also showed no significant changes (P = 0.130 and P = 0.069, respectively). Only two mild-to-moderate adverse events (injection-site reaction and conjunctivitis) occurred, both resolved with symptomatic management.

No treatment discontinuation, death, or worsening of renal function was reported.</p>Conclusion<p>Dupilumab effectively improves skin lesions, pruritus, sleep, quality of life, and frailty, while showing changes consistent with regulatory immune modulation in patients with stage 3–5 CKD and moderate-to-severe AD, with a favorable safety profile. Renal impairment alone should not be considered an absolute contraindication, although patients with advanced CKD require careful monitoring.</p>