In early-phase trials, dupilumab, a fully human mAb targeting IL-4 receptor �, markedly improved disease activity, but the effect of IL-4/IL-13 blockade on AD at the molecular level has not been characterized.OBJECTIVES: We sought to evaluate dupilumab modulation of the AD molecular signature.METHODS: We performed transcriptomic analyses of pretreatment and posttreatment skin biopsy specimens from patients with moderate-to-severe AD treated weekly with 150 or 300 mg of dupilumab or placebo.RESULTS: Exacerbation of the AD transcriptome was observed in placebo-treated patients.