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Semaka A, Salopek TG. Risk of Developing Melanoma With Systemic Agents Used to Treat Psoriasis: A Review of the Literature. J Cutan Med Surg 2021; 26:87-92. [PMID: 34392725 PMCID: PMC8750137 DOI: 10.1177/12034754211038509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Psoriasis is a chronic inflammatory skin disease induced by
autoimmune-like dysregulation of the immune system. Treatment
options have drastically evolved in recent years, and treatment
advances that target specific cytokines and other molecules
involved in dysregulation have had a profound effect in
controlling the disease. Objective We reviewed the literature to assess the risk of developing
melanoma with conventional therapies and newer agents used to
treat psoriasis. Methods A comprehensive literature search using Medline (via Ovid) and
Embase was conducted. Results The majority of studies reviewed reported insignificant results.
Potential risk for melanoma was identified for only 3 out of 15
anti-psoriatic treatments analyzed: adalimumab (relative risk
1.8, 95% CI 1.06-3.00), etanercept (relative risk 2.35, 95% CI
1.46-3.77) and infliximab (Empirical Bayes Geometric Mean 7.90,
95% CI 7.13-8.60). The confidence intervals provided are from
prior studies. There are not enough collective data on newer
agents to make any conclusions on risk. Conclusions We were unable to identify any substantial risk for developing
melanoma due to the use of anti-psoriatic treatments. Until
additional long-term registry data become available, it would be
prudent to continue screening patients with psoriasis at
baseline and periodically for melanoma when these agents are
used.
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Affiliation(s)
- Amy Semaka
- 3158 Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Thomas G Salopek
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Chen W, Ding Y, Lu J, Shi Y, Gao Y, Peng C. Efficacy and survival of infliximab in psoriasis patients: A single-center experience in China. Dermatol Ther 2020; 33:e14227. [PMID: 32844504 DOI: 10.1111/dth.14227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/16/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022]
Abstract
Psoriasis is a chronic, systemic disease that requires long-term management. Biologic agents have been used widely against psoriasis, such as infliximab. We analyzed the survival and discontinuation rates of infliximab when treating psoriasis under real-world conditions in China. Patients with moderate-to-severe psoriasis treated with infliximab in Shanghai Skin Disease Hospital from January 2015 to April 2020 were included in our retrospective study. Information from their medical records (clinical characteristics, Psoriasis Area Severity Index [PASI] score, laboratory results, and time of discontinuation) was collected through the Shanghai Skin Disease Hospital database. The survival of infliximab was assessed with Kaplan-Meier plots and multivariate Cox regression. Forty-two patients who underwent treatment were assessed retrospectively (38.1% had been diagnosed with psoriatic arthritis [PsA]). The discontinuation rate was 57.1%, the mean survival time of discontinuation was 57 weeks for patients with PsA vs 69 weeks for those without PsA (P = .5993). The cholesterol level (P = .003) and lymphocyte percentage (P = .010) were associated with longer survival of infliximab according to Cox regression analysis. Our study revealed that infliximab had a similar drug survival as previous studies, the high cholesterol level and lymphocyte percentage might function as negative predictor for infliximab persistence.
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Affiliation(s)
- Wenjuan Chen
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Jiajing Lu
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yunlu Gao
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Chen Peng
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
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