Rate of serious infection in patients who are prescribed systemic biologic or nonbiologic agents for psoriasis: A large, single center, retrospective, observational cohort study

Dermatol Ther. 2017 Sep;30(5). doi: 10.1111/dth.12529. Epub 2017 Aug 10.

Abstract

Background: Systemic biologic and nonbiologic agents used to treat psoriasis may or may not contribute to serious infection (SI) risk. Safety data, particularly for biologic agents, and associated risk for SI, are scarce. The study's aim was to explore the risk for SI in psoriasis patients exposed to systemic biologic or nonbiologic agents.

Methods: A large, single-center electronic medical record repository was searched between January 2010 and December 2014. Records for patients prescribed a systemic agent for psoriasis (SAP) with psoriasis or psoriatic arthritis diagnoses were included (ICD-9 codes 696.1 and 696.0, respectively). SIs were those who required hospitalization, and/or injectable antibacterial, antiviral or antifungal therapy. SIs occurring within 120 days after exposure to a SAP, were included for study.

Results: A total of 1,346 patients were exposed to a SAP between January 2010 and December 2014; 27 (2%) had a SI. Comparing biologic and nonbiologic agent exposure, no statistically significant difference for risk of SI was detectable (p = .83).

Conclusion: In this population, the SI rate for biologic and nonbiologic systemic agents was clinically indistinguishable, thereby supporting consideration of the entire spectrum of available systemic therapeutic agents, both biologic and nonbiologic agents, for management of moderate to severe psoriasis.

Keywords: psoriasis; severe infection; systemic therapy.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Arthritis, Psoriatic / drug therapy*
  • Biological Factors / adverse effects
  • Biological Factors / therapeutic use
  • Cohort Studies
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / therapeutic use*
  • Female
  • Humans
  • Infections / epidemiology*
  • Infections / etiology
  • Male
  • Middle Aged
  • Psoriasis / drug therapy*
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Biological Factors
  • Dermatologic Agents