Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8716099 | Journal of Investigative Dermatology | 2018 | 22 Pages |
Abstract
Serious infection is a concern for patients with psoriasis receiving biologic therapies. We assessed the risk of serious infections for biologics used to treat psoriasis by comparison with a cohort receiving non-biologic systemic therapies in a propensity score-weighted Cox proportional hazards model using data from the British Association of Dermatologists Biologic Interventions Register. Overall, 1,352; 3,271; and 994 participants were included in the etanercept, adalimumab, ustekinumab cohorts, respectively, and 3,421 participants were in the non-biologic cohort. A total of 283 patients had a serious infection; the incidence rates with 95% confidence intervals (CI) per 1,000 person-years were as follows: non-biologic, 14.2 (11.5-17.4); etanercept, 15.3 (11.6-20.1); adalimumab, 13.9 (11.4-16.6); and ustekinumab, 15.1 (10.8-21.1). No significant increases in the risk of serious infection were observed for etanercept (hazard ratio [HR]Â = 1.10, 95% CIÂ = 0.75-1.60), adalimumab (HRÂ = 0.93, 95% CIÂ = 0.69-1.26), or ustekinumab (HRÂ = 0.92, 95% CIÂ = 0.60-1.41) compared with non-biologic systemic therapies or methotrexate-only (etanercept: HRÂ = 1.47, 95% CIÂ = 0.95-2.28; adalimumab: HRÂ = 1.26, 95% CIÂ = 0.86-1.84; ustekinumab: HRÂ = 1.22, 95% CIÂ = 0.75-1.99). The risk of serious infection should not be a key discriminator for patients and clinicians when choosing between non-biologic systemic therapies, etanercept, adalimumab, and ustekinumab for the treatment of psoriasis.
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Authors
Zenas Z.N. Yiu, Catherine H. Smith, Darren M. Ashcroft, Mark Lunt, Shernaz Walton, Ruth Murphy, Nick J. Reynolds, Anthony D. Ormerod, Christopher E.M. Griffiths, Richard B. Warren, BADBIR Study Group BADBIR Study Group,