Denpa News Biologics have revolutionized the treatment of psoriasis. Initially, there was a risk of toxicity, but after 20 years of experience, biologics prove to be very safe and we can reassure patients.
The article by Penso et al. confirms this feeling, especially for IL-17 and IL-23 inhibitors, but also for older TNF inhibitors. Of course, the authors conclude that “the risk of serious infections was increased in new users of infliximab and adalimumab compared to etanercept,” but what exactly does this mean?
The study examined nearly 16,000 patients taking adalimumab, so the study has tremendous statistical power to spot even minor differences. The rate of serious infections for etanercept was approximately 2.5 per 100 patient-years; for adalimumab, it was 2.8.
This difference may be statistically significant but of little clinical significance. Where the study shows a high risk, the risk remains low. For IL-17 and IL-23 inhibitors, the study showed no increased risk of serious infections, and for ustekinumab, the rate of serious infections was even lower (approximately 20-33%) than for etanercept.
Association Between Biologics Use and Risk of Serious Infection in Patients With Psoriasis.
L Penso, R Dray-Spira, A Weill et al. JAMA Dermatol. 2021; 157 (9): 1056-1065