Abstract: 【Abstract】 Objective To analyze the drug survival rate and safety of dupilumab in the treatment of atopic dermatitis （AD） in elderly patients. Methods Clinical data were collected from patients diagnosed with AD and treated with dupilumab at the Hospital of Dermatology, Chinese Academy of Medical Sciences from May 2021 to May 2023, and were retrospectively analyzed. The patients aged ≥ 60 years were selected as a study group, and disease severity-matched patients aged ＜60 years served as a control group. Follow-up was conducted from the start of treatment until 24 weeks after the start of treatment. Drug survival rate and safety were analyzed and compared between the two groups. Drug survival rate was determined through Kaplan-Meier survival analysis; differences in drug survival rate between the two groups were analyzed using the log-rank test; chi-square test was used to compare the reasons for treatment discontinuation between the two groups. Results The study group and the control group each included 45 patients with AD, and the disease severity of patients in the study group was matched with that in the control group. At 24 weeks after the start of treatment, there was a significant difference in the overall drug survival rate of dupilumab between the study group （37.8%, 17/45） and the control group （57.8%, 26/45; P = 0.030）. Among the 45 elderly patients with AD in the study group, a significant difference was observed in the proportion of patients with nodular prurigo phenotype between the patients who completed the 24-week treatment （4/17） and those who did not complete （0, P = 0.007）. Main reasons for dupilumab withdrawal in the 28 patients in the study group were poor response （8/28, 28.6%）, followed by unaffordability （5/28, 17.9%） and persistent clinical remission （4/28, 14.3%）, and the adverse reactions included conjunctivitis （2 cases） and suspected systemic anaphylaxis （3 cases）; the main reasons for dupilumab discontinuation in 19 patients in the control group were poor response（7/19, 36.8%） and persistent clinical remission （6/19, 31.6%）, and the adverse reaction was injection site reaction in 1 case; there was no significant difference in the composition of reasons for drug withdrawal between the two groups. Conclusion Dupilumab generally exhibited good safety in elderly patients with AD, but its drug survival rate was lower than that in the younger patients.

Key words: Dermatitis, atopic, Elderly patients, Dupilumab, Drug survival rate, Safety