Long-term use of biological agents such as IL-4Rα inhibitors (e.g., dupilumab) or IL-5/IL-13-targeted formulations that may inhibit immune surveillance and increase susceptibility to infection (e.g., tuberculosis reactivation, bacterial/fungal infection), also theoretically raise the risk of malignancy, although the current evidence is inconclusive (156). This evidence concerns the gene IL13 and tuberculosis.