Long-term use of guselkumab in psoriasis treatment does not increase cancer risk
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Key takeaways:
- Malignancy rates in guselkumab-treated patients were comparable with the rates in psoriasis and general U.S. populations.
- The long-term use of guselkumab does not increase the risk for cancer.
Long-term use of guselkumab in the treatment of psoriasis does not yield increased cancer rates compared with the general and psoriasis populations, according to a study.
“Safety of biologic therapies over time is an important topic of concern for both patients and dermatologists,” Andrew Blauvelt, MD, MBA, investigator at the Oregon Medical Research Center, told Healio. “Risk of developing cancer in patients with psoriasis on long-term biologic therapy has been of particular interest, given the long-standing boxed warning for lymphoma for patients receiving [tumor necrosis factor] blockers.”
In this analysis, researchers evaluated the malignancy rates in patients with moderate to severe psoriasis treated with guselkumab, a selective interleukin (IL)-23 inhibitor, for up to 5 years compared with the general and psoriasis patient populations. Malignancy rates were measured per 100 patient-years (PY) and excluded nonmelanoma skin cancer (NMSC) and cervical cancer in situ.
Safety data were pooled from the VOYAGE 1 and VOYAGE 2 phase 3 studies in which patients were randomly assigned to placebo, guselkumab 100 mg or adalimumab 80 mg at baseline.
Of the 1,721 guselkumab-treated patients, 78.4% received the study drug for the entire 5-year treatment period.
During the follow-up, 24 patients had NMSC (0.34 per 100 PY) and 32 had malignancies excluding NMSC (0.45 per 100 PY). Overall, the combined malignancy rate among both guselkumab groups was 0.74 per 100 PY (95% CI, 0.56-0.97) with no evidence of an increasing trend.
These findings were comparable to the malignancy rate among other psoriasis patients (0.68 per 100 PY) according to the Psoriasis Longitudinal Assessment and Registry. Additionally, these guselkumab rates were comparable to the expected rates in the general U.S. population (standardized incidence ratio, 0.93).
“We found no evidence of increased cancer rates and no evidence of particular types of cancers in these patients,” Blauvelt said. “These data support the view that long-term IL-23 inhibition in general, and long-term use of guselkumab in particular, do not increase rates of cancer.”
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