Biologic Therapy and Malignancy Risk in Psoriasis: A Retrospective Cohort Study

Area of Science:

• Dermatology
• Oncology
• Pharmacology

Background:

• Psoriasis is a chronic inflammatory condition with increasing use of biologic therapies.
• The long-term safety of biologic therapy, particularly regarding malignancy risk, requires thorough investigation.

Purpose of the Study:

• To compare the incidence of malignancy in psoriasis patients receiving continuous biologic therapy versus topical monotherapy.
• To identify potential risk factors for malignancy within the biologic-treated cohort.

Main Methods:

• Retrospective analysis of 446 psoriasis patients (May 2010-March 2023).
• Comparison of malignancy incidence using Kaplan-Meier method and Cox proportional hazards regression with propensity score adjustment.
• Subgroup analysis within the biologic-treated group to identify additional risk factors.

Main Results:

• Overall malignancy incidence was 11.2%; 4.4% in the biologic group vs. 18.2% in the topical group (p < 0.0001).
• Biologic therapy was associated with a significantly reduced malignancy risk (HR: 0.316; p = 0.0211).
• Family history of malignancy was an independent risk factor for malignancy in biologic-treated patients (HR: 9.01; p < 0.05).

Conclusions:

• Biologic therapy demonstrates a significantly lower risk of malignancy compared to topical monotherapy in psoriasis patients.
• Family history of malignancy is a significant risk factor for developing cancer in patients treated with biologics.
• Individualized cancer risk assessment is crucial for treatment selection in psoriasis management.