Assessment of Primary Malignancy Risk after Initiation of Biologic Therapy in Patients with Psoriasis
Limited evidence exists regarding the long-term oncologic safety of biologic therapies, particularly IL-17 inhibitors and IL-23 inhibitors, in the management of psoriasis. This propensity score–matched retrospective cohort study assessed the risk of developing a primary malignancy within 10 years af...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-11-01
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| Series: | JID Innovations |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667026725000530 |
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| Summary: | Limited evidence exists regarding the long-term oncologic safety of biologic therapies, particularly IL-17 inhibitors and IL-23 inhibitors, in the management of psoriasis. This propensity score–matched retrospective cohort study assessed the risk of developing a primary malignancy within 10 years after exposure to a Food and Drug Administration–approved biologic among patients with psoriasis compared with that among biologic-naïve controls. After propensity score matching, 32,230 biologic-exposed patients were further grouped into cohorts of TNF inhibitors (n = 16,011), IL-23 inhibitors (n = 5604), IL-12/23 inhibitors (n =3856), and IL-17 inhibitors (n = 5467). During a 10-year period, TNF inhibitor–treated patients had a reduced risk of developing any primary malignancy compared with biologic-naïve patients with psoriasis (hazard ratio [HR] = 0.80; 95% confidence interval [CI] = 0.73–0.87). Similarly, a lower incidence of any malignancy was observed among patients on IL-23 inhibitors (HR = 0.83; 95% CI = 0.68–1.02), IL-12/23 inhibitors (HR = 0.85; 95% CI = 0.71–1.03), or IL-17 inhibitors (HR = 0.87; 95% CI = 0.73–1.04); however, the differences did not reach statistical significance. TNF inhibitor users were less likely to develop nonmelanoma skin cancer (HR = 0.82; 95% CI = 0.71–0.96) than controls, and the risk of nonmelanoma skin cancer did not significantly differ among users of IL-23 inhibitors (HR = 1.09; 95% CI = 0.77–1.55), IL-12/23 inhibitors (HR = 1.22; 95% CI = 0.90–1.64), or IL-17 inhibitors (HR = 1.03; 95% CI = 0.77–1.38). Exposure to any biologic class did not associate with the risk of developing melanoma or lymphoid/hematopoietic malignancies. Overall, these results provide evidence for the long-term oncologic safety of biologic therapies in the management of psoriasis. |
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| ISSN: | 2667-0267 |