In:
Journal of the European Academy of Dermatology and Venereology, Wiley
Abstract:
The risk of infections among patients with psoriasis undergoing interleukin (IL)‐23 inhibitors (IL‐23i) and IL‐17 inhibitors (IL‐17i) is yet to be exhaustively determined. Objective To assess the risk of infectious complications in patients with psoriasis managed by IL‐23i and IL‐17i with tumour necrosis factor inhibitors (TNFi) as a comparator. Methods A global cohort study comprised two distinct analyses comparing patients with psoriasis under different therapeutic modalities; (i) new users of IL‐23i ( n = 5272) versus TNFi ( n = 5272) and (ii) new users of IL‐17i ( n = 15,160) versus TNFi ( n = 15,160). Study groups were compared regarding the risk of 26 different infections. Propensity score matching was conducted to optimize between‐group comparability. Results Patients under IL‐23i had a lower risk of otitis media (HR, 0.66; 95% CI, 0.44–0.97), encephalitis (HR, 0.18; 95% CI, 0.04–0.78), herpes zoster (HZ; HR, 0.58; 95% CI, 0.41–0.82), hepatitis B virus (HBV) reactivation (HR, 0.24; 95% CI, 0.12–0.47), cytomegalovirus (HR, 0.25; 95% CI, 0.07–0.86), influenza (HR, 0.52; 95% CI, 0.38–0.71) and parasitic diseases (HR, 0.78; 95% CI, 0.64–0.95). IL‐17i was associated with a decreased risk of pneumonia (HR, 0.76; 95% CI, 0.68–0.85), septicaemia (HR, 0.84; 95% CI, 0.72–0.97), upper respiratory tract infection (HR, 0.84; 95% CI, 0.77–0.92), HZ (HR, 0.79; 95% CI, 0.67–0.92), HBV (HR, 0.59; 95% CI, 0.46–0.76) and hepatitis C virus (HR, 0.71; 95% CI, 0.57–0.88) reactivation, cytomegalovirus (HR, 0.58; 95% CI, 0.36–0.93), Epstein–Barr virus (HR, 0.38; 95% CI, 0.19–0.75), influenza (HR, 0.70; 95% CI, 0.61–0.81) and parasitic diseases (HR, 0.80; 95% CI, 0.72–0.88). Conclusion Compared with TNFi, IL‐23i and IL‐17i are associated with decreased risk of several infectious diseases. These agents might be preferred in patients with susceptibility to infections.
Type of Medium:
Online Resource
ISSN:
0926-9959
,
1468-3083
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
2022088-1
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