Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Risk of Infection in Psoriasis with Systemic Medications

Among a large cohort of patients with psoriasis treated with systemic medications, new users of apremilast, etanercept, and ustekinumab had a decreased rate of serious infection compared with methotrexate. Using medical and outpatient pharmacy claims from 2 large US heath insurance claims databases, the study included 107,707 patients. Prescription claims for acitretin, adalimumab, apremilast, etanercept, infliximab, methotrexate, or ustekinumab were studies. The primary outcome was serious infection. Researchers found:

  • The pooled PS-matched analysis yielded a decreased rate of overall serious infection in users of apremilast, etanercept, and ustekinumab compared with methotrexate.
  • A different rate of overall serious infection was not found among users of acitretin, adalimumab, and infliximab compared with methotrexate.
  • There was a significantly increased risk of cellulitis among users of acitretin compared with methotrexate in subanalysis.


Dommasch ED, Kim SC, Lee MP, Gagne JJ. Risk of serious infection in patients receiving Systemic medications for the treatment of psoriasis. [Published online ahead of print May 10, 2019. JAMA Dermatol. doi:10.1001/jamadermatol.2019.1121.