Serious infections among a large cohort of subjects with systemically treated psoriasis - 27/12/17
Abstract |
Background |
Biologic therapy is effective for treatment of moderate-to-severe psoriasis but may be associated with an increased risk for serious infection.
Objective |
To estimate the serious infection rate among patients with psoriasis treated with biologic as compared with nonbiologic systemic agents within a community-based health care delivery setting.
Methods |
We identified 5889 adult Kaiser Permanente Northern California health plan members with psoriasis who had ever been treated with systemic therapies and calculated the incidence rates and 95% confidence intervals (CIs) for serious infections over 29,717 person-years of follow-up. Adjusted hazard ratios (aHRs) were calculated using Cox regression.
Results |
Adjusting for age, sex, race or ethnicity, and comorbidities revealed a significantly increased risk for overall serious infection among patients treated with biologics as compared with those treated with nonbiologics (aHR, 1.31; 95% CI, 1.02-1.68). More specifically, there was a significantly elevated risk for skin and soft tissue infection (aHR, 1.75; 95% CI, 1.19-2.56) and meningitis (aHR, 9.22; 95% CI, 1.77-48.10) during periods of active biologic use.
Limitations |
Risk associated with individual drugs was not examined.
Conclusion |
We found an increased rate of skin and soft tissue infections among patients with psoriasis treated with biologic agents. There also was a signal suggesting increased risk for meningitis. Clinicians should be aware of these potential adverse events when prescribing biologic agents.
Le texte complet de cet article est disponible en PDF.Key words : biologics, epidemiology, psoriasis, serious adverse infections, soft tissue infections, TNF-α
Abbreviations used : aHRs, CI, IL, IR, KPNC, SSTI, TNF-α
Plan
| Supported by Pfizer Inc and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant K24 AR069760 to MA). |
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| Disclosure: In addition to research support from Pfizer Inc, Dr Asgari and Dr Quesenberry have received research support from Valeant Pharmaceuticals and Mr Ray has received research support from Merck & Co, Genentech, and Purdue Pharma. Dr Geier is an employee of Pfizer, Inc. Dr Dobry has no conflicts of interest to declare. |
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| Reprints not available from the authors. |
Vol 77 - N° 5
P. 838-844 - novembre 2017 Retour au numéro
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