ORIGINAL RESEARCH article
Front. Med.
Sec. Dermatology
This article is part of the Research TopicType 2 Inflammatory Skin Diseases: Novel Therapies and Clinical InsightsView all 7 articles
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
Provisionally accepted
Khalaf Kridin1
Katja Bieber2
Henning Olbrich2
Dagmar von Bubnoff2Gema Hernandez3Henner Zirpel2
Nikolas von Bubnoff2
Diamant Thaci2
Ralf J Ludwig2*- 1Bar-Ilan University, Ramat Gan, Israel
- 2Department of Dermatology, University of Lübeck, Lübeck, Germany
- 3Universidad Politecnica de Madrid, Madrid, Spain
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Background: 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. Objectives: Clarify the association between AD and lymphoma risk and extend to non-dermatological type 2 inflammatory diseases (T2IDs). Assess the impact of dupilumab on lymphoma risk in AD and non-dermatological T2IDs. Methods: Retrospective cohort study using TriNetX database. Propensity-score-matching allowed for better comparability, and sensitivity analyses ensured robustness. Results: 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). In over 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 towards reduced risks. This decreased risk associations were most evident in non-dermatological T2IDs (n=16,908 per group). Limitations: Retrospective data analysis, data quality, possible false registration of ICD-10-codes. Conclusion: T2IDs, including AD are associated with a significantly increased risk for lymphoma. Treatment with dupilumab partially ameliorates this risk association, especially for NHL.
Keywords: atopic dermatitis, Dupilumab, Lymphoma, Mycosis Fungoides, Real-world, Sézary disease, TriNetX, type 2inflammatory diseases
Received: 10 Sep 2025; Accepted: 12 Dec 2025.
Copyright: © 2025 Kridin, Bieber, Olbrich, von Bubnoff, Hernandez, Zirpel, von Bubnoff, Thaci and Ludwig. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ralf J Ludwig
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