Risk of infections in patients with psoriasis treated with biologic agents and new oral small molecules: BIOBADADERM...

Area of Science:

• Dermatology
• Pharmacovigilance
• Infectious Diseases

Background:

• Infections are common adverse events in systemic psoriasis therapy.
• Understanding infection risks associated with biologics and oral small molecules is crucial for patient safety.

Purpose of the Study:

• To analyze and compare the incidence rates of overall, serious, and specific infections among different systemic treatments for psoriasis.
• To evaluate the safety profile of biologics and oral small molecules regarding infection risk, using adalimumab as a reference.

Main Methods:

• Utilized data from the BIOBADADERM registry, including 4,820 patients and 20,829 patient-years of follow-up.
• Calculated adjusted incidence rate ratios using propensity score analysis to compare treatments.
• Identified and categorized infections, including serious and non-serious events.

Main Results:

• The overall incidence of serious infections was low (5.33%), with infliximab having the highest rate. Pneumonia and COVID-19 pneumonia were the most frequent serious infections.
• Risankizumab and ustekinumab demonstrated significantly lower overall infection risks compared to adalimumab.
• Specific treatments showed varying risks: higher Candida risk with bimekizumab, brodalumab, secukinumab, and ixekizumab; reduced respiratory infection risk with guselkumab, secukinumab, ixekizumab, and ustekinumab; lower COVID-19 risk with ixekizumab.

Conclusions:

• Systemic psoriasis treatments generally have a favorable safety profile concerning serious infections.
• Certain biologics, such as risankizumab and ustekinumab, may offer a reduced risk of overall infections compared to adalimumab.
• Monitoring for specific infection types, like Candida and respiratory infections, is important based on the chosen treatment.