TOPLINE:

In a cohort study, ustekinumab was associated with a numerically lower cancer risk in patients with psoriasis, but no statistically significant differences in risk were seen between three biologics.

METHODOLOGY:

• Researchers conducted a nationwide cohort study involving patients with psoriasis in Denmark using an active comparator, new-user design to emulate a head-to-head randomized trial.
• The analysis involved 2878 new biologic users (mean age, 44.6 years; 62.8% men); 2001 patients initiated adalimumab, 286 initiated secukinumab, and 591 initiated ustekinumab, three biologics for which there is now long-term follow-up data.
• A 12-month lag time after treatment initiation and discontinuation was applied to account for cancer latency.
• The primary outcome was first incidence of any cancer (nonmelanoma skin cancer was excluded).

TAKEAWAY:

• Using 12-month lag times, the numbers of first cancers diagnosed were 36 (4120 person-years), 5 (706 person-years), and 10 (2242 person-years) in the adalimumab, secukinumab, and ustekinumab groups, respectively.
• The 5-year standardized cancer absolute risks were 0.040 for adalimumab, 0.036 for secukinumab, and 0.024 for ustekinumab.
• Using 12-month lag times, standardized estimates suggest a 5-year risk for cancer that is 41% lower with ustekinumab (P = .06) and 12% lower with secukinumab (P = .77) than with adalimumab, but neither comparison was statistically significant.
• With 24-month lag times, standardized estimates suggest a 56% lower 5-year cancer risk with ustekinumab than with adalimumab (P < .001).

IN PRACTICE:

“We found no substantial differences in cancer risk between the treatment groups,” the authors wrote. “Risk estimates for ustekinumab were numerically lowest; although precision was limited for secukinumab and should be interpreted with caution, the low incidence suggests a clinically reassuring signal given the growing use of IL-17 inhibitors,” they added, noting that the results need to be confirmed with larger studies looking at specific cancers.

SOURCE:

The study was led by Christopher Willy Schwarz, MD, Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark, and was published online in a research letter on October 22 in JAMA Dermatology.

LIMITATIONS:

The study could not assess risks for specific cancers, and unmeasured confounding might have influenced the results, and results should be considered comparative estimates of risk, not causal associations, according to the authors.

DISCLOSURES:

The authors did not disclose funding information. Schwarz and other authors reported receiving travel grants and personal fees from Johnson & Johnson, AbbVie, Novartis, LEO Pharma, and several other drug companies. One author reported being employed at MC2 Therapeutics. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.