The Risk of Lymphoproliferative Disorders and Skin Cancers in Patients with Psoriasis and Inflammatory Bowel Disease Administered Biologics

Abstract

Few large population-based studies have investigated the effects of biologic agents on the risks of lymphoproliferative disorders (LPDs) and skin cancers in patients with psoriasis and inflammatory bowel disease (IBD). The objective of this study is to determine the effects of biologic agents on the risk of LPDs and skin cancers in South Korean patients with psoriasis and IBD. The Korean Health Insurance Review and Assessment Service database was reviewed, and patients newly diagnosed with psoriasis or IBD between 2008 and 2019 were included. The effects of exposure to biologics on the risk of cancer were assessed using multivariable Cox regression models. The study included 191,678 patients with psoriasis, 23,640 with Crohn’s disease (CD), and 66,730 with ulcerative colitis (UC). The tumor necrosis factor (TNF)-α inhibitor was associated with increased risks of overall lymphoma (adjusted hazard ratio (aHR), 2.93; 95% confidence interval (CI), 1.01–8.50), non-Hodgkin lymphoma (NHL) (aHR, 2.98; 95% CI, 1.02–8.69), and cutaneous lymphoma (aHR, 3.46; 95% CI, 1.07–11.21) in patients with psoriasis. TNF-α inhibitor exposure was associated with increased risks of overall lymphoma (aHR, 3.70; 95% CI, 1.81–7.55) and NHL (aHR, 3.72; 95% CI, 1.81–7.62) in patients with CD, whereas it did not increase the risks of cancer in patients with UC. In conclusion, treatment with TNF-α inhibitors can increase the risks of LPDs in patients with psoriasis or CD.