# Dupilumab treatment is not associated with changes in lymphoma risk in atopic dermatitis and other type 2 inflammatory diseases: data from a large-scale retrospective cohort study

## TL;DR

This study finds that atopic dermatitis and related inflammatory diseases increase lymphoma risk, but dupilumab treatment does not raise this risk and may even reduce it.

## Contribution

The study provides new evidence that dupilumab treatment does not increase lymphoma risk and may partially reduce it in patients with type 2 inflammatory diseases.

## Key findings

- Atopic dermatitis and non-dermatological T2IDs are associated with increased lymphoma risk.
- Dupilumab treatment does not increase lymphoma risk and may reduce it, especially for non-Hodgkin lymphoma.
- The risk reduction effect of dupilumab is more evident in non-dermatological T2IDs.

## Abstract

The association between atopic dermatitis (AD) and lymphoma risk remains inconclusive. Dupilumab, approved for moderate-to-severe AD, has been linked to an increased lymphoma risk, raising significant concerns.

The objective of the study was to clarify the association between AD and lymphoma risk and extend to non-dermatological type 2 inflammatory diseases (T2IDs). This study also aimed to assess the impact of dupilumab on lymphoma risk in AD and non-dermatological T2IDs.

A retrospective cohort study was conducted using the TriNetX database. Propensity-score matching allowed for better comparability, and sensitivity analyses ensured robustness.

Among 801,508 cases and controls, AD was associated with an increased risk of lymphoma, e.g., cutaneous T-cell lymphoma (CTCL) and non-Hodgkin lymphoma (NHL). Among 14.4 million cases and controls, non-dermatological T2IDs also conferred an increased lymphoma risk. In the comparison of AD patients treated with dupilumab versus other systemic treatments (n = 7,840 per group), dupilumab exposure did not alter the risk for lymphomas but tended toward reduced risks. This decreased risk association was most evident in non-dermatological T2IDs (n = 16,908 per group).

Retrospective data analysis, data quality, possible false registration of ICD-10-codes.

T2IDs, including AD, are associated with a significantly increased risk for lymphoma. Treatment with dupilumab partially ameliorates this risk association, especially for NHL.