ORCID

0009-0000-3072-6732 (Ro), 0009-0004-4995-841X (Ormaza Vera), 0000-0003-1242-7960 (Adawi), 0000-0002-6783-1904 (Enos)

Document Type

Article

Publication Date

2025

DOI

10.1016/j.xjidi.2025.100397

Publication Title

JID Innovations

Volume

5

Issue

6

Pages

100397 (1-10)

Abstract

Limited evidence exists regarding the long-term oncologic safety of biologic therapies, particularly interleukin (IL)-17 inhibitors (IL-17i) and IL-23i, in the management of psoriasis. This propensity-score-matched retrospective-cohort study assessed the risk of developing a primary malignancy within 10-years following exposure to an FDA-approved biologic among psoriasis patients compared to biologic-naïve controls. After propensity-score-matching, 32,230 biologic-exposed patients were further grouped into cohorts of tumor necrosis factor inhibitors (TNFi, n=16,011), IL-23i (n=5,604), IL-12/23i (n=3,856), and IL-17i (n=5,467). During a 10-year period, TNFi-treated patients had a reduced risk of developing any primary malignancy compared to biologic-naïve psoriasis patients [HR 0.80(0.73-0.87)]. Similarly, a lower incidence of any malignancy was observed among patients on IL-23i [HR 0.83(0.68-1.02)], IL-12/23i [HR 0.85(0.71-1.03], or IL-17i [HR 0.87(0.73-1.04)]; however, the differences did not reach statistical significance. TNFi-users were less-likely to develop non-melanoma skin cancer (NMSC)[HR 0.82(0.71-0.96)] compared to controls, and the risk of NMSC did not significantly differ among users of IL-23i [HR: 1.09(0.77, 1.55)], IL-12/23i [HR: 1.22(0.90, 1.64)], or IL-17i [HR: 1.03(0.77, 1.38)]. Exposure to any biologic class did not associate with the risk of developing melanoma or lymphoid/hematopoietic malignancies. Overall, these results provide evidence for the long-term oncologic safety of biologic therapies in the management of psoriasis.

Rights

© 2025 The Authors.

This is an open access article under the Creative Commons Attribution 4.0 International (CC BY 4.0) License.

Data Availability

Article states: "The data underlying this article are available within the main text. All data were retrieved from TriNetX, LLC, a platform ensuring compliance with the Health Insurance Portability and Accountability Act Security Rule for the protection of healthcare data. Because all patient data were deidentified, this study was deemed exempt for institutional review board review."

Original Publication Citation

Ro, C., Ormaza Vera, A., Adawi, W., Yap, A., & Enos, C. W. (2025). Assessment of primary malignancy risk following initiation of biologic therapy in psoriasis patients. JID Innovations, 5(6), 1-10, Article 100397. https://doi.org/10.1016/j.xjidi.2025.100397

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