Comparative pharmacovigilance of herpetic infections with dupilumab and JAK inhibitors in atopic dermatitis

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ID: 316399
2026
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Ranked #124 of 172 articles by views in clinical and experimental dermatology

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Abstract
BACKGROUND: Targeted systemic therapies for atopic dermatitis (AD), including biologics and Janus kinase (JAK) inhibitors, are increasingly used. However, comparative post-marketing evidence on herpetic infection-related safety signals across these therapies remains limited. OBJECTIVES: To compare safety signals of herpetic infections associated with targeted AD therapies using the Food and Drug Administration Adverse Event Reporting System (FAERS). METHODS: FAERS reports (Q2 2017 to Q1 2025) involving dupilumab, abrocitinib, baricitinib, or upadacitinib were included if these agents were designated as the primary suspect drug and the indication was AD. Disproportionality analyses using four algorithms were performed to detect signals for overall and virus-specific herpetic events. Subgroup analyses by age and sex and time-to-onset (TTO) analyses were conducted. RESULTS: All therapies demonstrated positive signals for herpetic infections. Baricitinib and abrocitinib showed the strongest signals, followed by upadacitinib, whereas dupilumab showed comparatively lower signals overall. Notably, dupilumab demonstrated a herpes simplex virus (HSV) signal comparable to abrocitinib and higher than upadacitinib, and a signal for eczema herpeticum (EH) was also identified. Signals were generally higher in females, except for upadacitinib. Age-stratified analyses showed varying signal patterns across age groups. Median TTO differed between therapies, with an earlier onset for upadacitinib. CONCLUSIONS: Herpetic infection reporting patterns differ across targeted AD therapies. Disproportionate reporting of HSV and EH with dupilumab warrants further investigation. Differences across sex, age groups, and TTO suggest potential heterogeneity in reporting patterns, which may reflect underlying patient characteristics and reporting behaviours.
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openalex_W7163888667 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Yaning Tian, Meixuan Li, Haoyang Hong, Rongfang Feng, Mai Luo, Yumin Xia
Journal clinical and experimental dermatology
Year 2026
DOI
10.1093/ced/llag242
URL
https://doi.org/10.1093/ced/llag242
Keywords Keywords not found

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