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Updated: Jul 4, 2026
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Safety of biologic therapy in psoriasis patients with a previous malignancy: Retrospective study using TriNetX
Alfonso Gotor-Rivera1, Julia Hernández-Sánchez2, Eva Chamorro-Jiménez1
1Department of Dermatology, University Hospital "12 de Octubre", Madrid, Spain.
Background And Objectives:
Evidence-based recommendations for the treatment of patients with psoriatic disease (PsO) and a prior history of malignancy are limited. This study aimed to compare the incidence of newly diagnosed neoplasms among patients with PsO and a previous malignancy receiving treatment with conventional systemic therapies, apremilast, or biologic agents.
Patients And Methods:
Retrospective observational study using TriNetX. PsO patients (ICD10:L40) with a previous diagnosis of cancer (ICD10:C00-D49) less than 5 years prior to systemic therapy initiation were selected. Outcomes evaluated included new documentation of neoplasms and all-cause mortality.
Results:
Patients under biologic therapy had a significantly lower new neoplasm documentation rate and all-cause mortality compared to classical agents (HR 0.857 and HR 0.705, respectively) and apremilast (HR 0.782 and HR 0.803, respectively) at 3 years follow-up. Only TNFi exhibited a significantly lower new neoplasm rate (HR 0.867, p < 0.0001) compared to classical agents; however, all biologic agents significantly decreased mortality. IL-23i was the only biologic therapy to significantly lower cancer recurrence risk (RR 0.878) compared to TNFi, with no differences in all-cause mortality.
Conclusions:
Biologic therapy for PsO may represent a safe treatment option in patients with a history of malignancy, compared with conventional systemic therapies or apremilast. Among biologic agents, IL-23 inhibitors appear to be associated with the most favorable safety profile.
