Immune checkpoint inhibitor therapy doubles psoriasis risk
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Key takeaways:
- Patients who received PD-1 or PD-L1 agents exhibited increased risk for psoriasis.
- Medical professionals should be cognizant of this elevated risk among immunotherapy-treated patients.
Patients with cancer who received immune checkpoint inhibitors exhibited increased risk for psoriasis compared with those treated with chemotherapy or targeted therapy.
“Although this adverse effect is relatively uncommon, it is important for medical professionals, clinicians and caregivers to be aware of this potential risk to improve skin health and ensure optimal cancer care,” Sheng-Yin To, BS, RPh, of National Defense Medical Center in Taiwan, and colleagues wrote.
Immune checkpoint inhibitors have improved outcomes for people with several cancer types; however, increased activation of immune effector cells can damage normal cells, resulting in immune-related adverse events.
To and colleagues conducted a nationwide cohort study to evaluate psoriasis risk associated with the use of immune checkpoint inhibitors among people with cancer.
Researchers used the Taiwan National Health Insurance database and the Taiwan Cancer Registry to identify patients who received antineoplastic medications for stage III or stage IV cancer between January 2019 and June 2021.
The analysis included data from 135,230 patients (mean age, 62.94 years; 45.1% women), 3,188 of whom were classified as immune checkpoint inhibitor users.
Incidence of psoriasis during the follow-up period served as the primary outcome.
Results showed a higher incidence of psoriasis among immune checkpoint inhibitor users than non-users (5.76 cases vs. 1.44 cases per 1,000 person-years).
Analyses adjusted for demographics and comorbidities showed psoriasis risk doubled among immune checkpoint inhibitor users (inverse probability of treatment weighting-adjusted HR = 3.31; 95% CI, 1.93-5.68; inverse probability of treatment weighting-adjusted subdistribution HR = 2.43; 95% CI, 1.41-4.2).
Researchers acknowledged study limitations, including a lack of data about patients’ lifestyle, BMI and environmental exposures, as well as lack of information about the varying degrees of psoriasis patients experienced.
Researchers also noted the Taiwan National Health Insurance database does not cover CTLA-4 inhibitors, so the data reported in the study only apply to patients who received PD-1 or PD-L1 inhibitors.
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