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Risk of Malignancies in Patients With Psoriasis Treated With IL-17 and IL-23 Inhibitors
TAKE-HOME MESSAGE
- This global cohort study assessed the risk of cancer in patients with psoriasis treated with IL-23 inhibitors (IL-23i) and IL-17 inhibitors (IL-17i) versus those treated with tumor necrosis factor inhibitors (TNFi) within the first 5 years after treatment initiation. IL-17i use was associated with reduced risks of non-Hodgkin lymphoma, colorectal cancer, hepatobiliary cancer, ovarian cancer, melanoma, and basal cell carcinoma. IL-23i use was associated with reduced risks of non-Hodgkin lymphoma, hepatobiliary cancer, and basal cell carcinoma. Both IL-17i and IL-23i were linked to lower cancer risks in a sensitivity analysis comparing the outcomes of patients receiving IL-17i and IL-23i with those of biologic-naïve patients.
- IL-17i and IL-23i treatments seem safe in terms of carcinogenesis, but more research is needed regarding patients with prior malignancies before starting treatment.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Cancer risk after long-term exposure to interleukin (IL)-23 inhibitors (IL-23i) and IL-17 inhibitors (IL-17i) remains to be delineated.
OBJECTIVE
To evaluate the risk of malignancies in patients with psoriasis treated with IL-23i and IL-17i relative to those prescribed tumor necrosis factor inhibitors (TNFi) during the first 5 years following drug initiation.
METHODS
A global population-based cohort study included two distinct analyses comparing patients with psoriasis under different therapeutic modalities; (i) new users of IL-17i(n=15,331) versus TNFi(n=15,331) and (ii) new users of IL-23i(n=5,832) versus TNFi(n=5,832).
RESULTS
Patients prescribed IL-17i experienced a decreased risk of non-Hodgkin lymphoma (NHL; HR, 0.58; 95% CI, 0.40-0.82; P=0.002), colorectal cancer (HR, 0.68; 95% CI, 0.49-0.95; P=0.024), hepatobiliary cancer (HR, 0.68; 95% CI, 0.58-0.80; P<0.001), ovary cancer (HR, 0.48; 95% CI, 0.29-0.81; P=0.005), melanoma (HR, 0.52; 95% CI, 0.37-0.73; P<0.001), and basal cell carcinoma (BCC; HR, 0.57; 95% CI, 0.48-0.67; P<0.001). IL-23i was associated with a reduced risk of NHL (HR, 0.39; 95% CI, 0.19-0.78; P=0.006), hepatobiliary cancer (HR, 0.44; 95% CI, 0.31-0.62; P<0.001) and BCC (HR, 0.76; 95% CI, 0.57-0.99; P=0.046). In a sensitivity analysis comparing patients managed by IL-17i and IL-23i with their biologic-naïve counterparts, these classes were associated with decreased risk of several malignancies.
CONCLUSION
IL-17i and IL-23i are associated with decreased risk of several malignancies. These findings should be considered prior to the prescription of biologics. This article is protected by copyright. All rights reserved.
Additional Info
Are interleukin 17 and interleukin 23 inhibitors associated with malignancies? - Insights from an international population-based study
J Eur Acad Dermatol Venereol 2023 Sep 20;[EPub Ahead of Print], K Kridin, M Abdelghaffar, N Mruwat, RJ Ludwig, D ThaçiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.