From the Journals

Psoriasis therapy with biologics not linked to increased cancer risk



Biologic treatments were not associated with an increased risk of cancer among patients with psoriasis in the medium term, in a study that analyzed data from patient registries.

“Cumulative length of exposure to biologics was not associated with the risk of developing cancers, even after controlling for the effect of age, gender, location,” as well as for previous exposure to methotrexate, cyclosporine, and phototherapy; duration of psoriasis; and comorbidities, reported Ignacio García-Doval, MD, of the Fundación Academia Española de Dermatología y Venereología, Madrid, and his associates.

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Data from four studies in Psonet from Israel, Italy, Spain, and the United Kingdom were analyzed, with each cancer case matched with up to four cancer-free controls in each cohort. Exposure to biologic therapies, methotrexate, and cyclosporine were calculated as cumulative years of exposure, as were other expected confounders such as duration of psoriasis, length of exposure to phototherapy, and the modified Charlson Comorbidity Index. There were data on 579 cancer cases and 2,671 matched controls; this included 41 cases of squamous cell carcinoma and 108 cases of basal cell carcinoma. Psonet is a surveillance network in Europe that is monitoring the longterm effectiveness and safety of systemic agents in patients with psoriasis.

The pooled adjusted odds ratio of cancer per year of biologic exposure was 1.02 (95% confidence interval, 0.92-1.13), demonstrating no significantly increased risk of cancer per cumulative year of biologic exposure for psoriasis therapy, Dr. García-Doval and his associates reported in the study, published in the British Journal of Dermatology. This was true even when broken down within the registries for comparison, and when analyzed by type of cancers, such as squamous cell carcinoma and basal cell carcinoma.

A limitation of the study was inadequate power to detect and compare risk between individual biologics, they said. Also, “as our data describe limited follow-up and latencies, it is still possible that a risk after longer periods of exposure and latencies exists.”

Most of the authors had numerous financial disclosures related to pharmaceutical companies. Psonet was supported with funds from the European Association of Venereology and Dermatology and the Italian Drug Agency. Funding for the individual registries includes support from pharmaceutical companies.

SOURCE: García-Doval I et al. Br J Dermatol. 2018 May 3. doi: 10.1111/bjd.16715.

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