WEDNESDAY, June 18, 2025 (HealthDay News) -- Patients with atopic dermatitis (AD) prescribed dupilumab have an increased relative risk for developing psoriasis, according to a study published online June 18 in JAMA Dermatology.

Teng-Li Lin, M.D., from the Buddhist Tzu Chi Medical Foundation in Chiayi, Taiwan, and colleagues compared psoriasis risk in patients with AD prescribed dupilumab versus other systemic agents in a population-based retrospective cohort study with three-year follow-up. After propensity score matching, 9,860 individuals newly prescribed dupilumab (dupilumab cohort) and 9,860 patients newly prescribed other systemic agents without dupilumab exposure (control cohort) were included.

The researchers found that compared with the control cohort, the dupilumab cohort had higher three-year cumulative psoriasis incidence (2.86 versus 1.79 percent). For dupilumab versus other systemic agents, the number needed to harm for psoriasis was 94. An increased risk for psoriasis was seen in the dupilumab cohort (hazard ratio, 1.58; 95 percent confidence interval, 1.25 to 1.99), while the risk for psoriatic arthritis was not significant (hazard ratio, 1.97; 95 percent confidence interval, 0.75 to 5.18). Various AD subgroups had an increased risk, including those without atopic comorbidities or with pretreatment immunoglobulin E levels less than 0.048 mg/dL (hazard ratios [95 percent confidence intervals], 1.42 [1.06 to 1.89] and 1.59 [1.26 to 2.01], respectively). Validation in patients with asthma without AD further supported the association between dupilumab and psoriasis (hazard ratio, 2.13; 95 percent confidence interval, 1.38 to 3.31).

"Despite the increased relative risk, an estimated number needed to harm of 94 reflected the limited clinical relevance of the absolute risk," the authors write. "This risk should be weighed against dupilumab’s proven efficacy in treating AD."

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