{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:04:45Z","timestamp":1789362285388,"version":"build-2803163510"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate dupilumab efficacy and safety in stage 3\u20135 chronic kidney disease (CKD) patients with moderate-to-severe atopic dermatitis (AD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 29 such patients receiving dupilumab who completed 12 and 24 weeks of follow-up. Assessments included Eczema Area and Severity Index (EASI), Pruritus Numeric Rating Scale (\n                      <jats:italic>N<\/jats:italic>\n                      RS), Sleep NRS, Dermatology Life Quality Index (DLQI), and Clinical Frailty Scale (CFS), eosinophils, interleukin-10 (IL-10), regulatory T cell (Treg) proportions, and renal function [estimated glomerular filtration rate (eGFR), serum creatinine, and urine protein-to-creatinine ratio (UPCR)]. Adverse events were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At week\u202f12, mean EASI score decreased from 34.94\u2009\u00b1\u20097.96 at baseline to 19.31\u2009\u00b1\u20096.09 (44.7% reduction), with 76.0% of patients achieving EASI-50. Pruritus NRS decreased from 7.72\u2009\u00b1\u20091.75 to 3.72\u2009\u00b1\u20091.75 (51.8% reduction), and 88.0% achieved a\u2009\u2265\u20094-point improvement. DLQI improved by 52.1%, and 100% of patients achieved a\u2009\u2265\u20094-point improvement. 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\u202f24, EASI-50, EASI-75, and EASI-90 response rates were 100%, 76.9%, and 7.7%, respectively; 100% of patients achieved \u22654-point improvements in both pruritus NRS and DLQI. IL-10 and Treg continued to rise, and CFS score was significantly reduced from baseline (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). Renal function parameters remained stable throughout the 24-week follow-up: mean eGFR showed a minimal decline from 37.93\u2009\u00b1\u200914.88 to 36.39\u2009\u00b1\u200914.77\u2005mL\/min\/1.73\u2005m\n                      <jats:sup>2<\/jats:sup>\n                      at week 24 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.073), serum creatinine and UPCR also showed no significant changes (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.130 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.069, 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats: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\u202f3\u20135 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1906235","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:35:06Z","timestamp":1789360506000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of dupilumab in moderate-to-severe atopic dermatitis with stage 3\u20135 chronic kidney disease: a retrospective real-world study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiali","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Dermatology, Shaoxing Second Hospital","place":["Shaoxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shaoxing 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