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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
The risk of malignancy among biologic-naïve pediatric psoriasis patients: A retrospective cohort study in a US claims
1Pfizer Inc, Collegeville, Pennsylvania; Evidera, Waltham, Massachusetts.
Insights
Pediatric psoriasis patients showed no increased overall cancer risk compared to those without psoriasis. However, a potential increased risk for lymphoma was observed when compared with the general population.
Area of Science:
- Dermatology
- Pediatrics
- Oncology
Background:
- Limited research exists on malignancy risk in children with psoriasis.
- Psoriasis is a chronic inflammatory condition affecting children and adults.
Purpose of the Study:
- To assess cancer risk in pediatric psoriasis patients.
- To compare malignancy incidence in biologic-naïve pediatric psoriasis patients with a matched control group.
Main Methods:
- Retrospective cohort study utilizing health plan claims data (1998-2008).
- Cancer incidence compared with US Surveillance, Epidemiology, and End Results (SEER) data and a matched pediatric population.
- Standardized incidence ratios (SIR) and Cox models were used for analysis.
Main Results:
- No significant difference in overall cancer incidence between pediatric psoriasis patients and the comparator cohort.
- A significantly increased lymphoma rate was observed in pediatric psoriasis patients compared to the general population (SIR 5.42).
- No significant increase in lymphoma risk was found when compared to the matched pediatric cohort.
Conclusions:
- Pediatric psoriasis patients do not exhibit a significantly increased overall cancer risk compared to their peers without psoriasis.
- A potential increased risk for lymphoma exists when comparing pediatric psoriasis patients to the general population.
- Claims data limitations, such as potential disease and outcome misclassification, should be considered.
Background:
Little published literature exists regarding malignancy risk in pediatric psoriasis patients.
Objective:
To compare malignancy risk in biologic-naïve pediatric psoriasis patients with a matched pediatric population without psoriasis.
Methods:
This retrospective cohort study used IMS LifeLink Health Plan Claims data covering 1998-2008. Cancer incidence was compared with the US Surveillance, Epidemiology, and End Results (SEER) data using standardized incidence ratios (SIR), and between cohorts using Cox models.
Results:
Among 9045 pediatric psoriasis patients and 77,206 comparators, 18 probable or highly probable cancers were identified. Pediatric psoriasis patients had a nonsignificantly lower incidence than comparators (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.05-3.54). The HR increased to 1.67 (95% CI 0.54-5.18) when cancer diagnosed during the first 90 days of follow-up was included. The pediatric psoriasis cohort had a significantly increased lymphoma rate compared with SEER (SIR 5.42, 95% CI 1.62-12.94), but no significant increase relative to the comparator cohort.
Limitations:
Misclassification of disease and outcome might have occurred with patients in the claims database.
Conclusion:
Patients with pediatric psoriasis showed no significant increase in overall cancer risk compared with those without psoriasis. A potential increased risk for lymphoma was observed when compared with the general population.
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