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Serious infections among a large cohort of subjects with systemically treated psoriasis.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2017 Nov; Vol. 77 (5), pp. 838-844. Date of Electronic Publication: 2017 Sep 13. - Publication Year :
- 2017
-
Abstract
- Background: Biologic therapy is effective for treatment of moderate-to-severe psoriasis but may be associated with an increased risk for serious infection.<br />Objective: To estimate the serious infection rate among patients with psoriasis treated with biologic as compared with nonbiologic systemic agents within a community-based health care delivery setting.<br />Methods: We identified 5889 adult Kaiser Permanente Northern California health plan members with psoriasis who had ever been treated with systemic therapies and calculated the incidence rates and 95% confidence intervals (CIs) for serious infections over 29,717 person-years of follow-up. Adjusted hazard ratios (aHRs) were calculated using Cox regression.<br />Results: Adjusting for age, sex, race or ethnicity, and comorbidities revealed a significantly increased risk for overall serious infection among patients treated with biologics as compared with those treated with nonbiologics (aHR, 1.31; 95% CI, 1.02-1.68). More specifically, there was a significantly elevated risk for skin and soft tissue infection (aHR, 1.75; 95% CI, 1.19-2.56) and meningitis (aHR, 9.22; 95% CI, 1.77-48.10) during periods of active biologic use.<br />Limitations: Risk associated with individual drugs was not examined.<br />Conclusion: We found an increased rate of skin and soft tissue infections among patients with psoriasis treated with biologic agents. There also was a signal suggesting increased risk for meningitis. Clinicians should be aware of these potential adverse events when prescribing biologic agents.<br /> (Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Age Distribution
Aged
Antibodies, Monoclonal, Humanized therapeutic use
Bacterial Infections epidemiology
Bacterial Infections immunology
Biological Products therapeutic use
California
Cohort Studies
Confidence Intervals
Databases, Factual
Drug-Related Side Effects and Adverse Reactions epidemiology
Female
Humans
Immunosuppressive Agents adverse effects
Immunosuppressive Agents therapeutic use
Incidence
Male
Middle Aged
Prognosis
Proportional Hazards Models
Psoriasis diagnosis
Reference Values
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Distribution
Antibodies, Monoclonal, Humanized adverse effects
Bacterial Infections chemically induced
Biological Products adverse effects
Drug-Related Side Effects and Adverse Reactions etiology
Psoriasis drug therapy
Psoriasis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 77
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 28917384
- Full Text :
- https://doi.org/10.1016/j.jaad.2017.07.047