Incidence and Risk Factors of Treatment-Emergent Eczematous Reactions in Patients with Psoriasis Treated with Biologics: A Systematic Review and Meta-Analysis

Background and objective: Treatment-emergent eczematous reactions have been reported in patients with psoriasis receiving biologic therapies, but their pooled incidence and associated factors remain unclear. We aimed to estimate the incidence and associated factors for treatment-emergent eczematous reactions in biologic-treated psoriasis patients.

Methods

We searched PubMed, EMBASE, and Web of Science (to Jan 2026) for studies reporting new-onset or exacerbated eczema in psoriasis patients treated with tumor necrosis factor (TNF), interleukin-17 (IL-17), interleukin-12/23 (IL-12/23), or IL-23 inhibitors. Two eligible studies of the oral tyrosine kinase 2 (TYK2) inhibitor deucravacitinib were analyzed separately as an exploratory subgroup. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, data were synthesized using a random-effects model with Freeman-Tukey double arcsine transformation. The primary outcome was the pooled incidence of treatment-emergent eczematous reactions. Secondary analyses examined differences according to biologic class, dosage, and demographic characteristics.