{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:09:31Z","timestamp":1789693771956,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A low risk of infections was found in the randomized placebo\u2010controlled trials of dupilumab in atopic dermatitis (AD). Dupilumab\u2010associated real\u2010life long\u2010term risk of infections remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the risk of infectious complications in patients with AD managed by dupilumab relative to those treated with methotrexate and cyclosporine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using the TriNetX global dataset, a retrospective cohort study comprised two distinct analyses comparing patients with AD under different treatments: (i) initiators of dupilumab (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910,913) versus methotrexate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910,913) and (ii) initiators of dupilumab (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096943) versus cyclosporine (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096943). Study groups were compared regarding the risk of 32 infections during the initial 3\u2009years following drug initiation. Propensity score matching was conducted to optimize inter\u2010group comparability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the first year of treatment, relative to methotrexate and cyclosporine, dupilumab was associated with a decreased risk of herpetic (HR, 0.59; 95% CI, 0.47\u20130.74 and HR, 0.65; 95% CI, 0.50\u20130.85, respectively) and non\u2010herpetic skin infection (HR, 0.55; 95% CI, 0.49\u20130.63 and HR, 0.68; 95% CI, 0.58\u20130.80, respectively) and systemic infections (HR, 0.39; 95% CI, 0.34\u20130.44 and HR, 0.47; 95% CI, 0.40\u20130.56, respectively). More specifically, relative to cyclosporine, dupilumab was associated with a reduced risk of pneumonia, urinary tract infection (UTI), upper respiratory tract infection (URTI), otitis media, sinusitis, herpes simplex, herpes zoster, hepatitis B virus (HBV) and HCV reactivation, cytomegalovirus, Epstein\u2013Barr virus, infective gastroenteritis, influenza, parasitic diseases, pneumocystis jirovecii pneumonia, cellulitis, folliculitis, mucocutaneous candidiasis and dermatophytosis. Compared to methotrexate, dupilumab conferred a decreased risk of the aforementioned infections (apart from herpes simplex and HCV reactivation) as well as septicaemia, meningitis, encephalitis, osteomyelitis and tuberculosis. The risk of eczema herpeticum was not increased among dupilumab\u2010treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dupilumab is associated with a reduced risk of a wide array of systemic and cutaneous infections. This agent might be preferred in patients with susceptibility to infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.20724","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T02:48:51Z","timestamp":1748227731000},"page":"2069-2078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The real\u2010world, long\u2010term risk of infections associated with dupilumab in atopic dermatitis: A global cohort study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-9151","authenticated-orcid":false,"given":"Khalaf","family":"Kridin","sequence":"first","affiliation":[{"name":"L\u00fcbeck Institute of Experimental Dermatology University of L\u00fcbeck  L\u00fcbeck Germany"},{"name":"Unit of Dermatology and Skin Research Laboratory Galilee Medical Center  Nahariya Israel"},{"name":"Azrieli Faculty of Medicine Bar\u2010Ilan University  Safed Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Abdelghaffar","sequence":"additional","affiliation":[{"name":"School of Medicine Royal College of Surgeons in Ireland  Busaiteen Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-6683","authenticated-orcid":false,"given":"Katja","family":"Bieber","sequence":"additional","affiliation":[{"name":"L\u00fcbeck Institute of Experimental Dermatology University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diamant","family":"Thaci","sequence":"additional","affiliation":[{"name":"Comprehensive Center for Inflammation Medicine University\u2010Hospital Schleswig\u2010Holstein  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1394-1737","authenticated-orcid":false,"given":"Ralf 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