Dermatology ·
BADBIR Cohort Finds No Increased Cancer Risk With Psoriasis Biologics
A linked UK and Republic of Ireland register study compared cancer outcomes in patients with moderate-to-severe psoriasis starting biologic or non-biologic systemic therapy. Across nearly 19,000 patients, adjusted analyses found no significant increase in cancer or keratinocyte carcinoma with biologics, although longer follow-up is needed for newer drug classes.
- Cancer risk was not significantly higher with biologic therapy.
- KC risk was also similar between treatment groups.
- Follow-up was shorter for newer biologic classes.
Researchers used data from the BADBIR register, linked to NHS Digital for cancer ascertainment, to compare cancer risk among biologic-naïve patients aged 16 years or older with chronic plaque psoriasis and no prior cancer. The cohort included patients starting biologic or non-biologic systemic therapy between 2007 and 2025. Cancer and keratinocyte carcinoma (KC) events within 12 months of treatment initiation were excluded; analyses included 18,894 patients for cancer and 19,144 for KC, with 58% receiving biologics in each group.
In lagged analyses, cancer incidence was 6.40 per 1,000 person-years among biologic initiators and 6.83 among non-biologic systemic therapy initiators. The adjusted hazard ratio (aHR) was 0.91 (95% CI 0.77–1.07). For KC, rates were 2.63 and 2.42 per 1,000 person-years, respectively, with an aHR of 1.05 (95% CI 0.81–1.35). Cancer risk did not differ significantly between IL-12/23 or IL-17 inhibitors and TNF inhibitors; KC risk was not elevated with IL-12/23 inhibitors.
These real-world findings do not show an increased cancer risk with biologics compared with non-biologic systemic therapies. The observational design cannot establish absence of risk, and follow-up was shorter for newer biologic classes. The authors call for larger studies with longer follow-up.
In practice
For adults with moderate-to-severe chronic plaque psoriasis starting systemic treatment, this linked-register cohort found no significant increase in cancer or keratinocyte carcinoma with biologics compared with non-biologic systemic therapies. The results offer real-world reassurance but do not establish that risk is absent or support changing treatment or surveillance practices. The study was observational, and follow-up was shorter for IL-12/23 and IL-17 inhibitors than for TNF inhibitors, so long-term risks with newer agents remain uncertain.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
Journal of the European Academy of Dermatology and Venereology: Risk of cancer in psoriasis patients treated with biologic therapy: A BADBIR cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.