Safety of dupilumab in atopic dermatitis (AD) was investigated in randomized controlled trials (RCT). However, head-to-head trials comparing with conventional systemic drugs are lacking and large real-world data on the long-term safety profile as compared are scarce. To compare long-term safety profile of dupilumab with conventional systemic drugs used in the management of moderate to severe AD. Data from electronic health records of AD patients treated with either dupilumab, azathioprine, Cyclosporine A, mycophenolate mofetil, methotrexate, or oral glucocorticoids were retrieved from the TriNetX US Collaborative Network. Risks of adverse events and new onset of type-2-inflammatory diseases within 5 years after treatment initiation was investigated. 5 propensity-matched cohorts, up to 18,708 individuals per cohort, were created. Dupilumab treatment displayed reduced risk for diseases of the circulatory, the upper respiratory, and the musculoskeletal system, infections, and type 2 diseases as compared to all other treatment options. In contrast risk for conjunctivitis was increased in dupilumab treated patients as compared to mycophenolate mofetil and methotrexate. Here presented data indicates that treatment with dupilumab for AD has reduced risk for adverse effects of conventional systemic drugs and thus might be safer. Obtained data should be verified in prospective studies. Moderate to severe atopic dermatitis can be treated by using conventional systemic treatments, monoclonal antibodies, or JAK inhibitors.Direct comparison on safety between conventional systemic treatments and monoclonal antibodies are lacking.Treatment with dupilumab reduced the risk for type 2 diseases and diseases affecting the upper respiratory and circulatory system in comparison to conventional systemic treatments.Dupilumab for the treatment of atopic dermatitis might have reduced risk for adverse effects of conventional systemic drugs and thus might be safer. Moderate to severe atopic dermatitis can be treated by using conventional systemic treatments, monoclonal antibodies, or JAK inhibitors. Direct comparison on safety between conventional systemic treatments and monoclonal antibodies are lacking. Treatment with dupilumab reduced the risk for type 2 diseases and diseases affecting the upper respiratory and circulatory system in comparison to conventional systemic treatments. Dupilumab for the treatment of atopic dermatitis might have reduced risk for adverse effects of conventional systemic drugs and thus might be safer.

This population-based cohort study performed utilizing the TriNetX database compares the risk of subsequent primary malignancies in patients diagnosed with melanoma or non-melanoma skin cancer, including basal cell carcinomas and squamous cell carcinomas. A case cohort was identified using ICD-10-CM codes for melanoma, basal cell carcinoma, and squamous cell carcinoma, as well as 11 of the most common primary malignancies as defined by the American Cancer Society. These included breast, prostate, lung, colorectal, bladder, non-Hodgkin’s lymphoma, kidney, uterine, leukemia, pancreas, and thyroid cancer.

A total of 130,526 melanoma patients and 130,526 non-melanoma skin cancer patients were identified after propensity score matching for demographics. The adjusted risk ratios revealed that melanoma patients had a significantly increased risk of developing breast, prostate, lung, kidney, pancreatic, and thyroid cancer compared to NMSC patients. No significant differences were found in the risk of developing colorectal cancer, prostate cancer, bladder cancer, non-Hodgkin’s lymphoma, or leukemia between the two groups.

Overall, this TriNetX database study underscores the importance of tailored cancer surveillance, particularly for breast, prostate, lung, kidney, pancreatic, and thyroid cancer in melanoma survivors. Future research should focus on exploring the mechanisms behind the differential cancer risks observed in this study and refining screening strategies for higher-risk populations.

IntroductionTo verify our hypothesis that psoriatic arthritis (PsA) is mainly genetically predetermined and distinct from psoriasis (PsO), we use the TriNetX database to investigate whether intrinsic factors outweigh externals in PsA emergence in PsO patients.MethodsWe conducted three retrospective cohort studies utilizing information from the TriNetX network, whether (a) PsO patients with type 2 diabetes mellitus (DM) face an elevated risk of developing PsA compared to those without type 2 DM; (b) PsO patients who smoke face a higher risk of PsA; and (c) PsO patients with type 2 DM who smoke are more likely to develop PsA than those who do not smoke.ResultsPsO patients with type 2 DM exhibited an elevated risk of developing PsA [hazard ratio (HR), 1.11; 95% CI 1.03–1.20], with the combined outcome demonstrating a heightened HR of 1.31 (95% CI 1.25–1.37). PsO patients with a smoking history exhibited an elevated risk of developing PsA (HR, 1.11; 95% CI 1.06–1.17), with the combined outcome demonstrating a heightened HR of 1.28 (95% CI 1.24–1.33). PsO patients with type 2 DM and a history of smoking were not found to be associated with an increased risk of developing PsA (HR, 1.05; 95% CI 0.92–1.20). However, the combined result revealed a higher risk of 1.15 (95% CI 1.06).DiscussionThese findings suggested that intrinsic factors outweigh external factors in PsA emergence in PsO patients. Further studies may focus on genetic disparities between PsO and PsA as potential risk indicators rather than solely on phenotypic distinctions.

Network of healthcare organizations, together with data partners in Brazil, South Korea, and Japan, to bring clinical facts on more than 250 million patients around the world. Federated model so users of this data are ensured new patients, observations, and results every day, all harmonized to standard terminology like ICD-10 and LOINC without any data wrangling required at the point of care. The raw data is not available to authors of papers and papers in medicine are being retracted.

Supplementary materials for a study examining the impact of vitamin D deficiency on overall survival in cancer patients receiving immune checkpoint inhibitors

Values for Kaplan-Meier survival analysis in patients with TKI treatment.

Background: The impact of inhaled corticosteroid (ICS) in the interaction between asthma, COVID-19 and COVID-19 associated outcomes remain largely unknown. The objective of this study is to investigate the risk of COVID-19 and its related outcomes in patients with asthma using and not using inhaled corticosteroid (ICS).Methods: We used the TriNetX Network, a global federated network that comprises 55 healthcare organizations (HCO) in the United States, to conduct a retrospective cohort study. Patients with a diagnosis of asthma with and without ICS between January 2020 and December 2022 were included. Propensity score matching was used to match the case cohorts. Risks of COVID-19 incidence and medical utilizations were evaluated.Results: Out of 64,587 asthmatic patients with ICS and without ICS, asthmatic patients with ICS had a higher incidence of COVID-19 (Hazard ratio, HR: 1.383, 95% confidence interval, CI: 1.330–1.437). On the contrary, asthmatic patients with ICS revealed a significantly lower risk of hospitalization (HR: 0.664, 95% CI: 0.647–0.681), emergency department visits (HR: 0.774, 95% CI: 0.755–0.793), and mortality (HR:0.834, 95% CI:0.740–0.939). In addition, subgroup or sensitivity analyses were also conducted to examine the result of different vaccination status, disease severity, or COVID-19 virus variants.Conclusion: For asthmatic patients using ICS, risk of COVID-19 was significantly higher than non-users. The observed association could provide potential guidance for primary care physicians regarding the risk of COVID-19 in asthmatic patients.

We present additional data in Supplementary Table 1 ("Additional autoimmune diseases examined") and Supplementary Table 2 "Pre-PSM data on all AIDs" for "Risk of Cutaneous T-cell Lymphoma in Patients with Autoimmune Diseases: A Propensity Score-Matched Retrospective Cohort-Study of Patients Using the Trinetx Network." Data were extracted from electronic medical records in the United States from patients with autoimmune diseases and a comparison group of individuals without autoimmune diseases between April 6th 2004 and April 6th 2024 using the TriNetX platform.

This table contains data gathered from TriNetX and compares patients with a diagnosis of xanthelasma to patients with a diagnosis of a benign facial lesion after propensity matching to compensate for differences in nicotine dependence, age at index event, sex, race, and ethnicity.

Flow chart for Fungal PPI TriNetX Study

Baseline characteristics for patients with metastatic renal cell carcinoma receiving first-line tyrosine kinase inhibitors or immune checkpoint inhibitors.

Supplemental methods, data, figures, and tables from TriNetX for the manuscript entitled: "Increased risk of renal disease in patients with hidradenitis suppurativa: A retrospective cohort study utilizing TriNetX"

Values for Kaplan-Meier survival analysis in patients with IO treatment.

Multivariable analysis for overall survival in patients with metastatic renal cell carcinoma receiving first-line tyrosine kinase inhibitors or immune checkpoint inhibitors.

Supplemental Table for "Opioid prescribing patterns associated with nail biopsies: a TriNetX analysis"

Supplemental Methods for "Negative association of psoriasis with female sex hormone levels: a case-control study using TriNetX"

Supplementary data for manuscript

ObjectiveTo explore the associations between the use of immune checkpoint inhibitors (ICIs) and the risk of developing uveitis among cancer patients.MethodsCancer patients who received ICI therapy and a comparison group of cancer patients who did not receive ICI therapy were retrospectively recruited from the TriNetX electronic heath-record registry. The outcome of interest was the development of new-onset uveitis. Propensity score matching based on a 1:1 ratio was conducted in order to reduce bias. Multi-variate cox proportional hazard models and Kaplan Meier method were also utilized to assess for the risk of uveitis among cancer patients who received ICI therapy.Results71931 cancer patients (54.7% male; 76.5% white; mean age at index 63.6 ± 12.2 years) who received ICI treatment (ICI group) and 71931 cancer patients (54.7% male; 77% white; mean age at index 63.5 ± 12.4 years) who never received ICI (comparison group) were recruited. Associated Kaplan-Meier curves showed significantly increased uveitis risk among the ICI group for all follow-up years (p

Supplementary documents for "Incidence and Prevalence of Perioral Dermatitis in the United States: A Retrospective Cohort Study using TriNetX."

1. Supplementary Table 1
2. Supplementary eMethods

RationaleObesity hypoventilation syndrome (OHS) is often underdiagnosed, with significant morbidity and mortality. Bicarbonate, as a surrogate of arterial carbon dioxide, has been proposed as a screening tool for OHS. Understanding the predictors of serum bicarbonate could provide insights into risk factors for OHS. We hypothesized that the bicarbonate levels would increase with an increase in body mass index (BMI), since the prevalence of OHS increases with obesity.MethodsWe used the TriNetX Research Network, an electronic health record database with de-identified clinical data from participating healthcare organizations across the United States, to identify 93,320 adults without pulmonary or advanced renal diseases who had serum bicarbonate and BMI measurements within 6 months of each other between 2017 and 2022. We used linear regression analysis to examine the associations between bicarbonate and BMI, age, and their interactions for the entire cohort and stratified by sex. We also applied a non-linear machine learning algorithm (XGBoost) to examine the relative importance of age, BMI, sex, race/ethnicity, and obstructive sleep apnea (OSA) status on bicarbonate.ResultsThis cohort population was 56% women and 72% white and 80% non-Hispanic individuals, with an average (SD) age of 49.4 (17.9) years and a BMI of 29.1 (6.1) kg/m2. The mean bicarbonate was 24.8 (2.8) mmol/L, with higher levels in men (mean 25.2 mmol/L) than in women (mean 24.4 mmol/L). We found a small negative association between bicarbonate and BMI, with an expected change of −0.03 mmol/L in bicarbonate for each 1 kg/m2 increase in BMI (p < 0.001), in the entire cohort and both sexes. We found sex differences in the bicarbonate trajectory with age, with women exhibiting lower bicarbonate values than men until age 50, after which the bicarbonate levels were modestly higher. The non-linear machine learning algorithm similarly revealed that age and sex played larger roles in determining bicarbonate levels than the BMI or OSA status.ConclusionContrary to our hypothesis, BMI is not associated with elevated bicarbonate levels, and age modifies the impact of sex on bicarbonate.