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Cutaneous malignancy after biologic therapy for inflammatory disease: An active comparator, retrospective cohort study - 19/08/25

Doi : 10.1016/j.jaad.2025.05.1401 
Kyle C. Lauck, MD a, Areeba Ahmed, BS b, Michael J. Davis, MD c, M. Laurin Council, MD, MBA d, Kishwer Nehal, MD c, Murad Alam, MD, MBA, MSCI b,
a Division of Dermatology, Department of Medicine, Baylor University Medical Center, Dallas, Texas 
b Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois 
c Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York 
d Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri 

Correspondence to: Murad Alam, MD, MBA, MSCI, 676 N Saint Clair, Suite 1600, Chicago, IL 60611.676 N Saint ClairSuite 1600ChicagoIL60611

Abstract

Background

The role biologics play in skin cancer among patients with inflammatory disease (ID) is uncertain. Skin cancer risk in patients with ID is elevated regardless of therapy, and there is a paucity of longitudinal data evaluating biologics that accounts for these ID-related confounders.

Objective

To assess the risk of cutaneous malignancy after biologic therapy for ID using head-to-head comparisons to control confounding risks of ID.

Methods

Data from 1,759,200 patients (2004-2024) with psoriasis, rheumatoid arthritis, and inflammatory bowel disease in the TriNetX network were analyzed. The risk of cutaneous malignancy was calculated after exposure to biologic therapy. Propensity score matching was implemented to control for confounders.

Results

A total of 212,632 (12.1%) patients were prescribed biologics for ID. Risk analysis demonstrated a small but significant elevation in absolute risk of nonmelanoma skin cancer driven predominately by patients exposed to tumor necrosis factor inhibitors. No other agents analyzed individually demonstrated significant risk elevations.

Limitations

Limitations include a retrospective approach and inherent errors/underreporting in electronic medical records.

Conclusion

This study confirms the association of tumor necrosis factor inhibitors with nonmelanoma skin cancer. Other biologics including interleukin and Janus kinase inhibitors may contribute minimally to skin cancer risk in ID. These differences underscore the care and personalized approach necessary in biologic selection for patients with ID.

Il testo completo di questo articolo è disponibile in PDF.

Key words : biologic therapy, cutaneous malignancy, inflammatory bowel disease, Janus kinase inhibitors, psoriasis, rheumatoid arthritis

Abbreviations used : ARI, BCC, IBD, ID, IL, ILi, JAKi, MM, NMSC, PSM, RA, SCC, TNF, TNFi


Mappa


 Funding sources: This article has no funding source.
 Patient consent: Not applicable.
 IRB approval status: Data accessible via TriNetX is presented in aggregate form and only contains anonymized data as per the deidentification standard defined by the US Health Insurance Portability and Accountability Act (HIPAA) in section §164,514(a). Given this study used only deidentified data and did not involve individually identifiable patient data, this study was exempt from Institutional Review Board Approval.
 Reprint requests: Kyle C. Lauck, MD.


© 2025  Pubblicato da Elsevier Masson SAS.
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P. 724-732 - settembre 2025 Ritorno al numero
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