Cancer progression, recurrence, and infection outcomes in psoriasis patients with active or recent malignancy treated with biologic therapy: A cohort study showing comparable safety to conventional agents.

Abstract

Limited data exist on the safety of biologic agents in psoriasis patients with cancer, leading guidelines to recommend against their use within 5 years of cancer history. To evaluate the safety of biologic therapies in psoriasis patients with active or recent (≤5 years) cancer. A surveillance study of 333 cases with psoriasis and active cancer or a recent cancer history. Patients treated with conventional systemic agents served as comparators. Coprimary outcomes included progression- or recurrence-free survival and the incidence of severe infections. Over a median follow-up of 6 years, progression/recurrence rates per 100 patient-years were 10.7 (biologics) and 10.5 (conventional). The cumulative 1-year progression- or recurrence-free survival was 86% in both groups (P = .89). Overall, biologics did not affect cancer progression (hazard ratio, 1.02; 95% confidence interval, 0.59-1.77; P = .94). Predictors of progression or recurrence included impaired functional status, advanced cancer stage (hazard ratio per stage increment, 1.48; 95% confidence interval, 1.21-1.82; P < .001), and higher comorbidity burden. Observational design. Biologics were safe to use in psoriasis patients with cancer.