Cancer risks in patients with psoriasis administered biologics therapy: a nationwide population-based study

PurposeTo assess cancer risks in patients with psoriasis and the effect of TNF-& alpha; inhibitor and interleukin (IL)-12/23 inhibitor therapy on those cancer risks.MethodsUsing the Korean Health Insurance Review and Assessment Service database, patients with newly diagnosed psoriasis between 2008 to 2019 were included. Standardized incidence ratios (SIRs) of overall and specific cancers were calculated in patients with psoriasis. The effect of TNF-& alpha; inhibitor and IL-12/23 inhibitor exposure on the risk of cancers was assessed by multivariable Cox regression models.ResultsIn total, 191,678 patients with psoriasis were included in this study. The overall risk of cancer was significantly higher in patients with psoriasis than in the general population (SIR, 1.12; 95% confidence interval (CI), 1.09-1.14). TNF-& alpha; inhibitor users had a significantly higher risk for overall cancer (adjusted hazard ratio (aHR), 1.41; 95% CI 1.01-1.97). In contrast, IL-12/23 inhibitor exposure had a significantly lower risk for overall cancer (aHR, 0.57; 95% CI 0.37-0.87). Among specific cancers, the risks of non-Hodgkin lymphoma (aHR, 2.98; 95% CI 1.02-8.69) were increased by TNF-& alpha; inhibitor therapy, while the risk of other cancers, including nonmelanoma skin cancer (aHR, 2.31; 95% CI 0.51-10.46), was not significantly altered by TNF-& alpha; inhibitor therapy.ConclusionTNF-& alpha; inhibitor therapy in psoriasis is associated with a significantly increased risk of overall cancer and lymphoma, while the risk of solid organ cancer was not affected by this therapy. The IL-12/23 inhibitor is not associated with an increased risk of any cancer.

Automated summary

This study aimed to assess the cancer risks in patients with psoriasis and evaluate the impact of TNF-α inhibitor and IL-12/23 inhibitor therapy on these risks. The results showed that patients with psoriasis had a significantly higher overall cancer risk compared to the general population. TNF-α inhibitor therapy was associated with an increased risk of overall cancer and lymphoma, while IL-12/23 inhibitor therapy was not associated with an increased risk of any cancer.