Biologics cut mortality risk in psoriasis regardless of treatment duration

In patients with moderate-to-severe psoriasis, biologic agents seem to reduce mortality risk regardless of treatment duration, a recent study has found. Methotrexate, on the other hand, only shows a similar efficacy when used for at least a year.

The researchers performed a nested case-control analysis, where cases were defined as psoriasis patients who died. Controls were matched 1:4 in terms of age, race, sex, and geographic region. Methotrexate, tumour necrosis factor α inhibitors (TNFI), and ustekinumab were the medications evaluated. Exposure was defined as taking at least 1 dose within 3 months of death.

Of the 12,090 initial participants, 341 died and were identified as cases (mean age, 66.43±11.93 years; 60.41 percent male); 1,364 controls (mean age, 66.04±11.57 years; 60.41 percent male) were included.

Treatment with biologics (TNFI and ustekinumab) in the last 91 days significantly protected against all-cause mortality, and such an effect was apparent even when patients had been taking the medication for 1 day to <1 year (odds ratio [OR], 0.08, 95 percent confidence interval [CI], 0.03–0.23) or for ≥1 year (OR, 0.09, 95 percent CI, 0.06–0.13).

Methotrexate, on the other hand, could significantly reduce the risk of death only when it was being taken ≥1 year (OR, 0.08, 95 percent CI, 0.02–0.28).

TNFI and ustekinumab similarly showed strong suppressive effects against the risk of cardiovascular mortality or deaths due to other causes, regardless of treatment duration; methotrexate remained effective only when taken for longer periods of time.