Research Looks at Infection Risks Among Biologics for PsO and PsA

Patients with psoriasis or psoriatic arthritis who initiate ustekinumab compared with other biologic treatments or apremilast are less likely to be hospitalized for serious infection, suggest study findings published online ahead of print in Arthritis Care & Research.

“Other biologics and apremilast were associated with 1.4- to 3-times higher risk of hospitalized serious infections in psoriasis/psoriatic arthritis patients when compared with ustekinumab; such a safety profile should be considered when selecting appropriate treatment regimens in patients with psoriasis/psoriatic arthritis,” wrote corresponding author Seoyoung C. Kim, MD, of Brigham and Women’s Hospital/Harvard Medical School, and coauthors.

The cohort study tapped multiple databases to identify 123,383 patients with psoriasis or psoriatic arthritis who initiated adalimumab, apremilast, certolizumab, etanercept, golimumab, ixekizumab, secukinumab, or ustekinumab between 2009 and 2018. Researchers were interested in investigating serious bacterial, viral, or opportunistic infections requiring hospitalization in patients by medication.

According to the study, 1514 serious infections occurred over a total 117,744 person-years of follow-up, resulting in a crude incidence of 1.29 per 100 person-years. Incidence rates of serious infection among patients who initiated ustekinumab ranged between 0.59 and 0.95 per 100 person-years.

Compared with ustekinumab, combined weighted hazard ratios for serious infections were 2.98 for ixekizumab, 2.92 for infliximab, 1.84 for secukinumab, 1.74 for golimumab, 1.66 for adalimumab, 1.42 for apremilast, 1.39 for etanercept, and 1.09 for certolizumab.

—Jolynn Tumolo

Reference

Jin Y, Lee H, Lee MP, et al. Risk of hospitalized serious infection after initiating ustekinumab or other biologics for psoriasis or psoriatic arthritis. Arthritis Care Res. May 10, 2021.