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Infection risk among psoriasis biologic-new users: A cohort study on the French National Health Data System
Tran Trong Khoi Le1, Tat-Thang Vo1, Emilie Sbidian2
1Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE, Research unit EA 7379), Paris Est Créteil University UPEC, Créteil, France.
Journal of the American Academy of Dermatology
|January 23, 2026
Summary
Biologics for psoriasis generally have low infection risks. Ustekinumab and IL-23 inhibitors demonstrated the lowest overall risk for both inpatient and outpatient infections in a large cohort study.
Area of Science:
- Dermatology
- Immunology
- Pharmacovigilance
Background:
- Psoriasis treatment increasingly involves biologics.
- Comprehensive data on infection risks associated with biologics for psoriasis is limited.
Purpose of the Study:
- To evaluate inpatient and outpatient infection risks across different biologics used for psoriasis.
- To compare infection risk profiles of various biologic agents in a real-world setting.
Main Methods:
- A cohort study utilized French National Health Data System (2013-2022) data.
- 39,669 adult new biologic users with psoriasis were analyzed.
- Outcomes included time to infection hospitalization, time to first outpatient anti-infective use, and anti-infective coverage.
Main Results:
- Inpatient infections occurred at 27.1 per 1,000 person-years; median anti-infective coverage was 5.5%.
- Compared to adalimumab, ustekinumab, secukinumab, and risankizumab showed lower inpatient infection risk.
- Ustekinumab and IL-23 inhibitors exhibited the lowest overall risk for first inpatient or outpatient infection events.
Conclusions:
- Biologics for psoriasis are associated with low overall infection risks.
- Ustekinumab and IL-23 inhibitors appear to have the most favorable safety profile regarding infections.
- Limitations include lack of clinical data and focus on systemic anti-infectives.
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