814 Correlation between skin cytokine profile and response to dupilumab in atopic dermatitis

Dupilumab, a monoclonal antibody that inhibits IL4 and IL13, has significantly advanced the treatment of atopic dermatitis (AD). However, as few 1/3 patients with AD treated dupilumab achieve clear or almost skin. Although reasons for this are not fully understood, it been proposed suboptimal response in some may be related to immunologic heterogeneity AD. Here, we evaluate whether expression IL4, other cytokines correlate responsiveness We conducted retrospective cohort study 60 at our institution. Levels IL13 were determined using RNA situ hybridization (RISH) on archival diagnostic skin biopsies each patient. Cytokine profiles compared among complete/near complete responders (n=16), partial (n=37), those no clinical worsening (n=7). found correlated most closely responsiveness. Patients achieving had median 7.64 strongly positive (4+) cells per mm2 0.225 4+ whose worsened failed improve (p=0.033). clear/almost also greater expressing who responders, 0.675 (p<0.001). patterns provided additional information pattern response. These findings suggest molecular play role can evaluated histochemical staining approach specimens. This is limited by nature analysis. Prospective evaluation ongoing. As therapeutic armamentarium continues increase, methods help choose optimal agent will helpful. appears hold promise personalizing therapy