Dupilumab is the first and long-awaited biological for treatment of moderate to severe atopic dermatitis. In randomised clinical trials approximately 40% of patients using dupilumab 300 mg every two weeks were clear or almost clear of their eczema after 16 and 52 weeks. We now face the challenge of patient stratification to limit the budget impact of dupilumab and hope that more targeted therapies for atopic dermatitis will follow soon.