Biologic Agents May Up Risk of Squamous Cell Carcinoma Among Psoriasis Patients, Study Suggests

Biologic Agents May Up Risk of Squamous Cell Carcinoma Among Psoriasis Patients, Study Suggests

An increased incidence of cutaneous squamous cell carcinoma was found among psoriasis patients who were treated with biologic agents.

A study with those results, “Malignancy rates in a large cohort of patients with systemically treated psoriasis in a managed care population,” was published in the Journal of the American Academy of Dermatology.

Psoriasis is one of the most prevalent chronic inflammatory diseases, affecting 7.5 million people in the United States, according to the American Academy of Dermatology.

Patients with moderate-to-severe psoriasis often require treatment with systemic agents, many of which have immunosuppressive properties, leading to the sub-optimal function of the immune system. In this scenario, patients may have an increased risk of developing cancer, including non-melanoma skin cancer (NMSC).

Researchers in this study aimed to assess the rate of malignancy (excluding NMSC) and NMSC rate among psoriasis patients treated with biological agents.

Maryam M. Asgari, MD, MPH, from the Department of Dermatology, Massachusetts General Hospital, and Harvard Medical School in Boston, and her colleagues included 5,889 adult patients, identified through the Kaiser Permanente Northern California health plan. All patients had their psoriasis diagnosed from 1998 to 2011, and were treated with at least one systemic antipsoriatic agent.

The patients included 3,604 nonbiologic users and 2,285 ever-biologic users. Most biologic-exposed members were treated with tumor necrosis factor-alpha (TNF-a) inhibitors (2,214 patients, 97%), the researchers reported.

They also found that overall, incidence of cancer rates were comparable between biologic users nonbiologic users.

Furthermore, the results showed that patients exposed to a biologic agent had non-melanoma skin cancer rates that were 42% higher, which was driven largely by increased cutaneous squamous cell carcinoma risk.

“Our findings suggest that the use of biologics, the majority of which were [TNF-a] inhibitors, for treatment of psoriasis may increase the risk of [non-melanoma skin cancer] especially [cutaneous squamous cell carcinoma],” the researchers concluded according to a press release published on the website Healio. “But exposure to biologics does not appear to be associated with the overall occurrence of cancers, other than [non-melanoma skin cancer]. Routine dermatologic screening examinations may be warranted in patients with psoriasis exposed to biologics, especially among [non-melanoma skin cancer] subgroups, such as those who are older, fair-skinned and have been treated with ultraviolet radiation.”

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