JAMA Dermatol

Dupilumab linked to increased psoriasis risk in atopic dermatitis patients

June 23, 2025

Study details: This retrospective cohort study analyzed 214,430 adults with atopic dermatitis (AD) from the TriNetX Global Collaborative Network over a 3-year period. Researchers compared psoriasis incidence in patients newly prescribed dupilumab vs. those receiving other systemic agents (e.g., corticosteroids, methotrexate). Propensity score matching was used to balance cohorts (n=9,860 each) on demographics, comorbidities, labs, and prior treatments.

Results: The 3-year cumulative incidence of psoriasis was significantly higher in the dupilumab group (2.86%) than in controls (1.79%; P < .001), with a hazard ratio (HR) of 1.58 (95% confidence interval [CI], 1.25–1.99). This elevated risk was consistent across subgroups, including patients without atopic comorbidities (HR, 1.42) and those with low baseline IgE (<0.048 mg/dL; HR, 1.59). Notably, the association was also observed in asthma patients without AD (HR, 2.13), reinforcing a potential drug-related effect.

Clinical impact: While the absolute risk increase is modest, clinicians should be aware of the elevated psoriasis risk with dupilumab. Shared decision-making is essential, especially in patients with personal or family history of psoriasis, to balance this risk against dupilumab’s proven efficacy in AD.

Source:

Lin TL, et al. (2025, June 18). JAMA Dermatol. Psoriasis Risk in Patients With Atopic Dermatitis Treated With Dupilumab. https://pubmed.ncbi.nlm.nih.gov/40531497/