ArticleJID innovations : skin science from molecules to population health2025
Assessment of Primary Malignancy Risk after Initiation of Biologic Therapy in Patients with Psoriasis.
Article in JID innovations : skin science from molecules to population health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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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