Bio treatments for psoriasis & cancer risk

[Fred]

Findings from this large real world study showed no evidence of an increased risk of cancer among patients treated with biologics for psoriasis compared with non biologic systemic therapies among patients treated with IL-12/23i or IL-17i compared with TNFi.

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Background:
There are concerns that biologic therapies for psoriasis may increase cancer risk.

Objectives:
To compare risks of incident cancer excluding keratinocyte carcinomas (KC; hereafter referred to as cancer) and KC among patients with moderate-to-severe psoriasis treated with biologic versus non-biologic systemic therapies, and across biologic classes.

Methods:
Data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR), a UK and Republic of Ireland register collected 2007–2025, were linked to NHS Digital for enhanced cancer ascertainment. Biologic-naïve patients aged ≥16 years with chronic plaque psoriasis and no prior cancer or KC were included. Cancer or KC events occurring within 12 months of treatment initiation were excluded. Crude incidence rates per 1000 person-years (py) with 95% confidence intervals (CI) were calculated. Adjusted hazard ratios (aHRs; 95% CI) were estimated using propensity score-weighted flexible parametric survival models with multiple imputation for missing data.

Results:
The cancer and KC analyses included 18,894 and 19,144 patients, respectively (58% receiving biologics in both), reflecting differences in outcome-specific exclusion criteria. In 1-year lagged analyses, cancer incidence rates per 1000 person-years were 6.40 [95% CI 5.83–7.02] in biologic initiators and 6.83 [95% CI 6.01–7.76] in non-biologic systemic initiators, with an aHR of 0.91 [95% CI 0.77–1.07]. Corresponding KC incidence rates were 2.63 [95% CI 2.28–3.04] and 2.42 [95% CI 1.96–3.00], respectively, with an aHR of 1.05 [95% CI 0.81–1.35]. Follow-up was shorter for IL-12/23i and IL-17i than for TNFi. Cancer risk did not differ significantly for IL-12/23i or IL-17i versus TNFi, nor was KC risk elevated for IL-12/23i.

Conclusions:
This real-world study found no evidence of an increased risk of cancer or KC with biologic compared with non-biologic systemic therapies, or across the biologic classes. Larger studies with longer follow-up, particularly for newer biologics, are needed to clarify long-term risk.

Source: onlinelibrary.wiley.com

*Funding: British Association of Dermatologists

Biological Treatments For Psoriasis

[Waine]

I think ultimately it will result in more people getting cancer, but not for the reason one thinks. It's not the medication that will cause, but simply that you live longer, thereby increasing your risk. It's the same reason smoking bans lead to an increase in Alzheimer's. More people lived to an age to develop it.

[Fred]

I think ultimately it will result in more people getting cancer, but not for the reason one thinks. It's not the medication that will cause, but simply that you live longer, thereby increasing your risk. It's the same reason smoking bans lead to an increase in Alzheimer's. More people lived to an age to develop it.

Hadn't thought of it that way, but I'll take what ever extra I can get now. When I was younger I always thought I wouldn't get past 30, but now in my 70s every day is a bonus.