期刊
JOURNAL OF INVESTIGATIVE DERMATOLOGY
卷 138, 期 3, 页码 534-541出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jid.2017.10.005
关键词
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类别
资金
- British Association of Dermatologists (BAD)
- Pfizer
- Janssen Cilag
- AbbVie
- Novartis
- Samsung Bioepis
- Eli Lilly
- BAD
- University of Manchester
- National Institute for Health Research (NIHR) Doctoral Research Fellowship [DRF-2015-08-089]
- NIHR
- NIHR Manchester and the Guy's and St Thomas' Biomedical Research Centres
- Medical Research Council [MR/L011808/1]
- MRC [MR/L011808/1] Funding Source: UKRI
- National Institute for Health Research [NF-SI-0514-10125, DRF-2015-08-089] Funding Source: researchfish
Serious infection is a concern for patients with psoriasis receiving biologic therapies. We assessed the risk of serious infections for biologics used to treat psoriasis by comparison with a cohort receiving non-biologic systemic therapies in a propensity score-weighted Cox proportional hazards model using data from the British Association of Dermatologists Biologic Interventions Register. Overall, 1,352; 3,271; and 994 participants were included in the etanercept, adalimumab, ustekinumab cohorts, respectively, and 3,421 participants were in the non-biologic cohort. A total of 283 patients had a serious infection; the incidence rates with 95% confidence intervals (CI) per 1,000 person-years were as follows: non-biologic, 14.2 (11.5-17.4); etanercept, 15.3 (11.6-20.1); adalimumab, 13.9 (11.4-16.6); and ustekinumab, 15.1 (10.8-21.1). No significant increases in the risk of serious infection were observed for etanercept (hazard ratio [HR] = 1.10, 95% CI = 0.75-1.60), adalimumab (HR = 0.93, 95% CI = 0.69-1.26), or ustekinumab (HR = 0.92, 95% CI = 0.60-1.41) compared with non-biologic systemic therapies or methotrexate-only (etanercept: HR = 1.47, 95% CI = 0.95-2.28; adalimumab: HR = 1.26, 95% CI = 0.86-1.84; ustekinumab: HR = 1.22, 95% CI = 0.75-1.99). The risk of serious infection should not be a key discriminator for patients and clinicians when choosing between non-biologic systemic therapies, etanercept, adalimumab, and ustekinumab for the treatment of psoriasis.
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