Biologic Therapy for Psoriasis and Risk of Malignancies in a Hispanic Population: A Single Center Retrospective Cohort

Abstract

Objectives: Psoriasis is a chronic inflammatory autoimmune disease with an increasing burden. Biologic agents are considered a key treatment modality in improving quality of life for psoriasis patients. However, the potential carcinogenic effect of these agents has become a concerning factor due to their immunomodulatory effects. The purpose of this study is to evaluate differences in the incidence of skin and systemic malignancies in biologic-naïve patients vs biologic-treated patients. Methods: This retrospective study evaluated chart data from the University of Puerto Rico dermatology clinics, from August 2020 through January 2023. The inclusion criteria for biologic-naïve patients were to be 18 years or older, diagnosed with psoriasis, unexposed to previous systemic therapy, and with available baseline clinical characteristics. The biologic-exposed had to meet the same criteria and must have received at least 6 months of biologic therapy. Patients who had a previous history of phototherapy were excluded from the study. Results: A total of 402 patients were evaluated; 172 from the biologic naïve group and 230 from the biologic exposed group. The incidences of NMSC and systemic malignancy for the biologic-naïve group (2.32% and 1.74%) and the biologic-exposed group (2.17% and 2.60%) showed no significant difference (p-value =0.47). In the biologic-exposed group, patients exposed to adalimumab had the highest incidence of both NMSC and systemic malignancy. However, this difference was not statistically significant. The most common systemic malignancies were colorectal and prostate carcinomas. Conclusions: There was no significant difference in cancer incidence in patients treated with topical versus biologic therapy for psoriasis.