Psoriasis Therapy Linked to Cancer Risk

Long-term treatment with tumor necrosis factor-α (TNF-α) inhibitors may be associated with an increased risk for cancer in patients with psoriasis, according to a recent study.

Currently, the association between systemic therapy and cancer risk in psoriasis patients is not well understood.
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To explore this further, the researchers assessed 12,090 patients with psoriasis with no history of malignancy via nested case-control analyses. The researchers defined cases as first malignancy (other than nonmelanoma skin cancer) in the Psoriasis Longitudinal Assessment and Registry (PSOLAR).

The effects of methotrexate, ustekinumab, and TNF-α inhibitors on malignancy risk were evaluated. The researchers defined exposure as 1 or more doses of study therapy within 12 months of the onset of malignancy. Patients were further stratified based on the duration of therapy. Odds ratios of malignancies associated with therapy were estimated, and results were adjusted for potential confounders.

Of 12,090 patients, there were 252 cases of malignancy, matched with 1008 controls. Ultimately, results of the analysis demonstrated that methotrexate or ustekinumab use for any period of time was not associated with a higher risk for malignancy compared with no exposure. However, TNF-α inhibitor use for at least 12 months was associated with an increased risk for malignancy.

“Long-term [at least 12 months] treatment with a TNF-α inhibitor, but not methotrexate and ustekinumab, may increase risk for malignancy in patients with psoriasis,” the researchers concluded.

—Christina Vogt

Reference:

Fiorentino D, Ho V, Lebwohl MG, et al. Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry. J Am Acad Dermatol. 2017;77(5):845-854.e5. https://dx.doi.org/10.1016/j.jaad.2017.07.013.