IL-17 Inhibitors and the Risk of Malignancy
Abstract
The modern era of psoriasis treatment has provided dermatologists with an array of systemic medications to address this serious inflammatory skin disease. In most patients, psoriasis requires chronic treatment and management and, thus, long-term data on medication safety is of utmost importance. The risk of malignancy is a primary concern for both the prescribing dermatologist and the psoriatic patient.
Studies on commonly used systemic agents to treat psoriasis associated with malignancy have been previously reviewed. For example, there have been several reports on Epstein-Barr virus-associated lymphomas in psoriasis patients treated with methotrexate. The use of cyclosporine has been associated with a 2-fold increased risk of overall malignancy, and upward of 6-fold increased risk for squamous cell carcinoma (SCC), specifically. Psoralen combined with ultraviolet A phototherapy (PUVA) has been associated with an increased risk of non-melanoma skin cancers. Tumor necrosis factor alpha (TNFα) inhibitors have also been associated with an increased risk of both SCC and lymphoma. Given their relatively recent introduction, newer biologic agents, such as IL-17 inhibitors, have had limited data regarding malignancy risk.
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