Systemic treatments for psoriasis & infections in older patients

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How was the study conducted?

Design: Population-based cohort study using linked health administrative data.

Population: Adults age 66+ with psoriasis or psoriatic arthritis using systemic treatments in Ontario, Canada.

Study period: Between April 1, 2002 and December 31, 2020.

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Background:
Systemic treatments for psoriatic disease affect the immune system and may increase infection risk. Older adults are at high risk for infection, and the relative safety of systemic treatments for them is unknown.

Objective:
This study examined the association of systemic treatments for psoriatic disease with rates of serious infection among older adults.

Methods:
We conducted a cohort study used linked population-based health administrative data from 2002 to 2021 in Ontario, Canada.

Results:
Of 11,641 new users of systemic therapy, 53% were female, with a median age of 71. Over 4.8 years of follow-up, there were 1,967 serious infections. Serious infection rates per 100 person-years were 2.7 for methotrexate, 2.5 for other older drugs, 2.2 for anti-TNF biologics, 1.4 for other biologics, and 8.9 for tofacitinib. Methotrexate, older drugs, and anti-TNF biologics were not linked to serious infections, while other biologics had lower rates and tofacitinib had higher rates.

Conclusion:
Biologics targeting IL-12, IL-23, or IL-17 were associated with a lower rate of serious infection among older adults with psoriatic disease. These biologics may have important safety benefits for older adults with higher infection risk.

Source: odprn.ca