Psoriatic patients with cancer: a multicentric real-life study comparing Risankizumab and Apremilast

Evidence on the management of psoriasis in patients with a recent history of malignancy is limited, and safety data on systemic and biologic therapies in this setting are very important. Recent studies confirm the safety of anti-interleukin (IL) biological drugs in patients with psoriasis and a personal history of cancer.

To assess the safety and effectiveness of risankizumab (RISA) and apremilast (APRE) in psoriatic patients with a recent cancer diagnosis (<5 years) in a real-world setting.

Retrospective, multicentre, observational study including adult patients with psoriasis and recent oncologic history treated with RISA or APRE. Clinical characteristics, treatment safety, including cancer recurrence/progression, and effectiveness outcomes, were collected during follow-up.

Eighty-seven patients were included (RISA n=21; APRE n=66). Baseline characteristics were broadly comparable, although prior biologic exposure was more frequent in the RISA group. Over a mean follow-up of 30 months, both treatments showed acceptable safety profiles. No cancer recurrence or progression occurred in the RISA group, while one event was observed in the APRE group. Due to the extremely low number of oncologic events, analyses were descriptive. Risankizumab showed a higher effectiveness than Apremilast, with a significant improvement also in quality of life and well-being.

In this multicentre real-world cohort of psoriatic patients with recent malignancy, risankizumab and apremilast showed favourable safety during the study follow-up. Larger studies with longer follow-up are needed.