Risk of malignancy in patients with psoriasis receiving systemic medications: A nested case-control study
Funding information: Ministry of Science and Technology, Taiwan, Grant/Award Number: MOST 108-2314-B-075-041-MY3; Taipei Veterans General Hospital, Grant/Award Numbers: V110C-021, V111C-022
Abstract
Large-scale, real-world studies on the side effects of systemic therapies (including biologics) in patients with psoriasis are limited. We aimed to calculate the risk of malignancy in patients with psoriasis who were treated with systemic medications. Nested case-control analyses were performed among psoriasis patients without a history of malignancy. We recruited 4188 patients with newly diagnosed psoriasis and successive malignancies, and 8376 matched controls from the National Health Insurance Research Database in Taiwan. The therapy duration was within 5 years before malignancy onset and further stratified into two groups according to the duration of medication usage. Multivariate conditional logistic regression adjusted for potential confounders was used to estimate malignancy risk associated with systemic treatments. Among psoriasis patients, long-term (> 12 months) treatment with cyclosporine increased the risk of malignancy compared with no exposure (odds ratio, 1.57; p = 0.01). Short-term (≤ 12 months) or long-term (> 12 months) use of other systemic treatments, including methotrexate, azathioprine, systemic retinoids, mycophenolate mofetil, sulfasalazine, etanercept, adalimumab, and ustekinumab, was not associated with an increased risk of malignancy in patients with psoriasis. Long-term treatment with cyclosporine increased the risk of malignancy in patients with psoriasis by 1.57-fold.
CONFLICT OF INTEREST
The authors have no conflict of interest to report
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from Ministry of Health and Welfare. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the author(s) with the permission of Ministry of Health and Welfare.
