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Cohort study of malignancies and hospitalised infectious events in treated and untreated patients with psoriasis and a general population in the United States

BACKGROUND: Psoriasis is associated with risk of malignancy. Some psoriasis treatments may increase risk of hospitalised infectious events (HIEs). OBJECTIVE: To evaluate rates of malignancies and HIEs in psoriasis patients. METHODS: This retrospective cohort study utilised data from MarketScan(R) databases. Cohorts included: adult general population (GP), psoriasis patients, and psoriasis patients treated with nonbiologics, adalimumab, etanercept, infliximab, or phototherapy. Outcomes included incidence rates (IRs) per 10,000 person-years observation (PYO) for all malignancies excluding nonmelanoma skin cancer (NMSC), lymphoma, NMSC, and per 10,000 person-years exposure (PYE) for HIEs. RESULTS: IRs (95% confidence interval [CI]) for all malignancies except NMSC were 129 (127, 130) and 142 (135, 149) for GP (PYO=51,071,587) and psoriasis (PYO=119,432) cohorts, respectively; 10.9 (10.5, 11.3) and 12.9 (10.9, 14.8) for lymphoma; and 145 (144, 147) and 180 (173, 188) for NMSC. Rates for all malignancies excluding NMSC were similar among treatments but variable for lymphoma and NMSC. IRs (95% CI) for HIEs were 332 (256, 408) for the nonbiologic cohort (PYE=3,528); 288 (206, 370) for etanercept (PYE=6,563); 325 (196, 455) for adalimumab (PYE=2,772); 521 (278, 765) for infliximab (PYE=1,058); and 334 (242, 427) for phototherapy (PYE=1,797). IRs for HIEs were lowest for etanercept and higher in patients on baseline systemic corticosteroids across treatment cohorts. CONCLUSION: Malignancy rates were higher in psoriasis patients than the GP, but these treatments did not appear to increase malignancy risk. This article is protected by copyright. All rights reserved

Citation

Kimball, AB., Schenfeld, J., Accortt, NA., Anthony, M., Rothman, K., & Pariser, D. (2015). Cohort study of malignancies and hospitalised infectious events in treated and untreated patients with psoriasis and a general population in the United States. British Journal of Dermatology, 173(5), 1183-1190. DOI: 10.1111/bjd.14068

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