February 07, 2017
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Biologics for psoriasis may increase risk of squamous cell carcinoma

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Patients with psoriasis who were treated with biologics had an increased incidence of cutaneous squamous cell carcinoma, according to study results recently published in the Journal of the American Academy of Dermatology.

Researchers used the Kaiser Permanent Northern California health plan to identify 5,889 adult members with psoriasis diagnosed between 1998 and 2011 who were treated with at least one systemic antipsoriatic agent. The patients included 3,604 nonbiologic users and 2,285 ever-biologic users.

The researchers calculated malignancy rates per 1,000 person years.

Tumor necrosis factor-alpha (TNF-a) inhibitors were used as treatment for 2,214 biologic-exposed members (97%).

The incident cancer rates were similar between the ever-biologic users and the nonbiologic users (adjusted HR = 0.86; 95% CI, 0.66-1.13).

Patients exposed to a biologic had nonmelanoma skin cancer rates that were 42% higher (adjusted HR = 1.42; 95% CI, 1.12-1.8), which included an increased risk of cutaneous squamous cell carcinoma (adjusted HR = 1.81; 95% CI, 1.23-2.67).

“Our findings suggest that the use of biologics, the majority of which were [TNF-a] inhibitors, for treatment of psoriasis may increase the risk of [nonmelanoma skin cancer] especially [cutaneous squamous cell carcinoma],” the researchers concluded. “But exposure to biologics does not appear to be associated with the overall occurrence of cancers, other than [nonmelanoma skin cancer]. Routine dermatologic screening examinations may be warranted in patients with psoriasis exposed to biologics, especially among [nonmelanoma skin cancer] subgroups, such as those who are older, fair-skinned and have been treated with ultraviolet radiation.” – by Bruce Thiel

Disclosure: Asgari reports having a research contract with Valeant. Please see the full study for the other researchers’ relevant financial disclosures.