Abstract
Background
Safety outcomes from IL-17A inhibitors have not been fully evaluated.
Objective
Compare the risk of seven safety outcomes in patients with psoriasis who started treatment with either ixekizumab or secukinumab vs other biologics to treat psoriasis.
Methods
In this cohort study (Apr 2016 - Dec 2022), we used US claims data to assess the risk of infections, major adverse cardiac events (MACE), inflammatory bowel disease (IBD), malignancy, and anaphylaxis, in patients with psoriasis starting an IL-17A inhibitor vs other biologics (TNF, IL-12/23, or IL-23 inhibitors).
Results
Among 4261 IL-17A inhibitors users we observed no meaningfully increased risk of MACE (RR = 0.67, 0.27-1.63), or malignancy (RR = 0.92, 0.58-1.45) vs patients initiating other biologics. After propensity score matching IL-17A inhibitors users had a 3-fold increase in the risk of oral candidiasis (RR = 3.43; 1.48-7.84), a 19% increase in the risk of outpatient infections (RR = 1.19; 1.05-1.35) and a 40% increased risk of serious infections with wide confidence intervals (RR = 1.40; 0.72-2.71). We observed a signal for an increased risk of IBD based on very few events.
Conclusion
Patients with psoriasis using an IL-17A inhibitor had an increased risk of oral candidiasis and outpatient infections but no increase for MACE, anaphylaxis, or malignancy compared to other biologics.
Keywords
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
