ArticleJournal of the European Academy of Dermatology and Venereology : JEADV2025
Infection risk in atopic dermatitis patients treated with biologics and JAK inhibitors: BioDay results.
Article in Journal of the European Academy of Dermatology and Venereology : JEADV, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Large-scale meta-analysis of infection risk with JAK-STAT inhibitors in 29,000 patients.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Pooled it
- Dupilumab for the treatment of eczema molluscatum: A pediatric case report and systematic literature review.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026Pooled it
- JAK Inhibitor Safety in Atopic Dermatitis and Alopecia Areata: A 4.5-Year Real-World Retrospective Cohort Study.Dermatology and therapy · 2026Pooled it
- Long-Term Dupilumab Treatment Is Not Associated with an Increased Overall Risk of Infections in Adults with Moderate-to-Severe Atopic Dermatitis: Results from an Open-Label 5-Year Extension Study.Advances in therapy · 2026Trial
- The molecular mechanism of the adverse effects of the biological and small molecular drugs in the therapy of inflammatory skin diseases - psoriasis and atopic dermatitis.Annals of medicine · 2026Review
- Long-Term Disease Control During Continuous Treatment with Upadacitinib and Baricitinib for Moderate-to-Severe Atopic Dermatitis: a Real-World Monocentric Retrospective Study.Dermatology and therapy · 2026Article
- Interpreting infection-disease associations in psoriasis and atopic dermatitis.JAAD international · 2026Article
- Reply to: "Interpreting infection-disease associations in psoriasis and atopic dermatitis".JAAD international · 2026Article
- Dupilumab versus tralokinumab in atopic dermatitis: A propensity score adjusted comparison from BioDay.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Article
- Addressing potential bias when assessing safety of biologics and JAK inhibitors in atopic dermatitis.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Article
- Dermatologic Toxicities Induced by JAK Inhibitors.American journal of clinical dermatology · 2026Review
- Herpes Zoster in Patients Treated with JAK Inhibitors for Immune-Mediated Inflammatory Diseases: Incidence, Associated Factors and Vaccination Uptake in a Real-World Cohort.Journal of clinical medicine · 2026Article
- Safety of upadacitinib in atopic dermatitis in randomized clinical trials across 6 years.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Article
- Janus kinase inhibitors enhance the efficacy of dupilumab in refractory atopic dermatitis.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Article
- Real-World Effectiveness and Safety of Abrocitinib in Patients with Atopic Dermatitis: A 16-Week Single-Center Retrospective Cohort Study Compared with Upadacitinib and Baricitinib.Dermatology and therapy · 2026Article
- Review
- Efficacy and safety of dupilumab following discontinuation of JAK inhibitors in patients with moderate-to-severe atopic dermatitis: a single-center retrospective study.Frontiers in immunology · 2026Article
- Reassuring evidence on infection risk with dupilumab in atopic dermatitis: Lessons from real-world evidence.Journal of the European Academy of Dermatology and Venereology : JEADV · 2025Article
- Infection risk in atopic dermatitis patients treated with biologics and JAK inhibitors: BioDay results.Journal of the European Academy of Dermatology and Venereology : JEADV · 2025Article
- Atopic dermatitis: diagnosis, molecular pathogenesis, and therapeutics.Molecular biomedicine · 2025Review
Corrections and comments
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLimited data exist on the comparative risk of infections during biologic and Janus kinase inhibitor (JAKi) treatment for atopic dermatitis (AD) in daily practice.
objectivesTo assess the differential infection risk of biologic and JAKi treatment in patients with moderate-to-severe AD in a real-world setting.
methodsThis prospective, multicentre study evaluated treatment-emergent infections in patients (age ≥ 12 years) using biologics or JAKi from the BioDay registry from October 2017 to July 2024. Crude incidence rates were calculated per 100 patient-years (PY) per treatment. Cox regression for recurrent events, adjusted for potential confounders, was used to estimate hazard ratios (HR) for the rate of infections, with subgroup and sensitivity analyses in bio-/JAKi-naïve patients.
resultsIn total 1793 patients were included (4044.1 PY; 1886 biologic treatment episodes (TEs); 480 JAKi), with 794 infections. JAKi showed higher infection rates (58.4-65.5/100 PY) compared to biologics (13.6-22.0), especially for herpes infections (n = 195, 24.6%; JAKi 13.6-19.8 vs. biologicals 3.0-3.6). Cox regression indicated increased rates with JAKi (abrocitinib HR 4.1, 95% CI: 3.1-5.5; baricitinib HR 4.2, 95% CI: 2.9-6.2; upadacitinib HR 4.0, 95% CI: 3.2-5.0; all p < 0.0001) and a slight increase with tralokinumab (HR 1.4, 95% CI: 1.0-2.0, p = 0.039) compared to dupilumab. Sensitivity analyses confirmed these results, except for tralokinumab. Rates of severe infections were higher with JAKi compared to dupilumab, although absolute numbers were low and associations were not consistently significant. History of infection, predominantly viral or fungal skin infections (HR 1.9, 95% CI: 1.4-2.6, p < 0.0001; 2.4, 1.3-4.4, p = 0.003, resp.), was identified as an independent factor associated with infection.
conclusionsThis cohort study demonstrated an increased risk of infection during JAKi treatment compared to dupilumab for moderate-to-severe AD. These findings enhance understanding of the differential infection risk with targeted therapies in AD, aiding tailored treatment choices that consider patient-specific risks such as prior skin infections.
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