Safety Assessment of Conventional and Biological Systemic Therapy in Older Adults with Psoriasis, a Real-world Multicentre Cohort Study

Optimal selection of systemic therapy in older adults with psoriasis can be challenging, due to sparse evi-dence-based guidance. This multicentre retrospective study investigated the safety of systemic therapy with causality assessment in a real-world cohort of older adults (>= 65 years) with psoriasis. Data from 6 hospi-tals on (serious) adverse events were collected, cau-sality assessment performed and incidence rate ratios calculated. Potential predictors for adverse events -occurrence were studied using multivariable logistic regression analysis. In total, 117 patients with 176 treatment episodes and 390 patient-years were inclu-ded, comprising 115 (65.3%) and 61 (34.7%) treat- ment episodes with conventional systemic therapy and biologics/apremilast, respectively. After causality as-sessment, 232 of 319 (72.7%) adverse events remai-ned and were analysed further, including 12 serious adverse events. No significant differences in incidence rate ratios were found between the systemic treat-ment types. In regression analysis, increasing age was associated with causality assessed adverse events -occurrence (odds ratio 1.195; p=0.022). Comorbidity, polypharmacy, and treatment type were not associa-ted with causality assessed adverse events -occurren-ce. In conclusion, increasing age was associated with a higher causality assessed adverse events-occurrence. Causality assessed serious adverse events were rare, reversible and/or manageable in clinical practice. In conclusion, the safety profile of systemic antipsoriatic therapy within this population is reassuring.

Automated summary

This multicentre retrospective study examined the safety of systemic therapy in older adults with psoriasis and analyzed predictors for adverse events. The study found that increasing age was associated with a higher incidence of adverse events, while comorbidity, polypharmacy, and treatment type were not related to adverse event occurrence. Causality assessment showed that serious adverse events were rare and manageable in clinical practice, indicating a reassuring safety profile for systemic antipsoriatic therapy in this population.