A RECENT global retrospective cohort study has demonstrated that dupilumab, a monoclonal antibody used to treat atopic dermatitis (AD), offers a favorable cardiometabolic safety profile compared to traditional systemic agents such as methotrexate and cyclosporine. This finding is particularly significant for healthcare professionals managing patients with AD who are at increased risk for cardiovascular and metabolic disorders.
The study analyzed data from two patient groups: 10,151 individuals initiating dupilumab therapy compared to an equal number starting methotrexate, and 6,629 patients each for dupilumab and cyclosporine initiators. Over a 3-year follow-up period, researchers assessed the incidence of eight cardiovascular and four metabolic outcomes, employing propensity score matching to ensure comparability between groups.
Results indicated that, within the first year of treatment, dupilumab was associated with a significantly reduced risk of several conditions compared to methotrexate:
Peripheral vascular disease (PVD): 36% risk reduction (HR, 0.64; 95% CI, 0.45–0.90; P = 0.011)
Deep vein thrombosis (DVT): 58% risk reduction (HR, 0.42; 95% CI, 0.26–0.69; P < 0.001) Hypertension: 33% risk reduction (HR, 0.67; 95% CI, 0.58–0.79; P < 0.001) Type 2 diabetes mellitus (T2DM): 47% risk reduction (HR, 0.53; 95% CI, 0.42–0.68; P < 0.001) Obesity: 30% risk reduction (HR, 0.70; 95% CI, 0.58–0.86; P = 0.001) When compared to cyclosporine, dupilumab also demonstrated a lower risk of: Hypertension: 48% risk reduction (HR, 0.52; 95% CI, 0.45–0.62; P < 0.001) Hyperlipidemia: 41% risk reduction (HR, 0.59; 95% CI, 0.49–0.71; P < 0.001) T2DM: 38% risk reduction (HR, 0.62; 95% CI, 0.48–0.81; P < 0.001) These findings suggest that dupilumab may be a preferable treatment option in AD, especially those with existing cardiovascular or metabolic risk factors. The study's authors conclude that dupilumab's favorable cardiometabolic safety profile supports its use in this patient population. Reference: Kridin K et al. The cardiometabolic safety of dupilumab in atopic dermatitis: A global large-scale cohort study. Arch Dermatol Res. 2025;317(1):296. Anaya Malik | AMJ
