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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Risk of cancer in patients with psoriasis on biological therapies: a systematic review

E Peleva1, L S Exton2, K Kelley3

  • 1St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, U.K.

The British Journal of Dermatology
|July 20, 2017
PubMed
Abstract

Insights

Biological therapies for psoriasis may increase the risk of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma, with tumor necrosis factor inhibitors (TNFi). Further research is needed to confirm this association and understand cancer risk with these treatments.

Area of Science:

  • Immunology
  • Dermatology
  • Oncology

Background:

  • Biological therapies are effective for psoriasis but impact immune pathways.
  • Potential negative effects on cancer immunosurveillance exist.

Purpose of the Study:

  • To investigate the cancer risk in psoriasis patients receiving biological therapy.

Main Methods:

  • Systematic review of randomized controlled trials, prospective cohort studies, and systematic reviews.
  • Searched MEDLINE, Embase, and Cochrane Library up to August 2016.
  • Included studies comparing biological therapy for psoriasis to control populations.

Main Results:

  • Eight prospective cohort studies were included, primarily focusing on tumor necrosis factor inhibitors (TNFi).
  • An increased risk of nonmelanoma skin cancer (NMSC), especially squamous cell carcinoma, was observed with TNFi.
  • No increased risk was found for other cancers (lymphoma, melanoma, prostate, colorectal, breast).

Conclusions:

  • Identified studies had limitations including comparator choice, confounding factors, and latency periods.
  • Ongoing pharmacovigilance for cancer risk with biological therapies is necessary.
  • Further investigation into the NMSC risk associated with biological therapy is required, using prospectively collected data.

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