Review Highlights GI Risks for Biologic Rxs for Psoriasis

TOPLINE:

A review of 10 articles finds that nearly 9% of adverse event (AE) reports with biologics used to treat psoriasis were gastrointestinal (GI)-related and suggests that the relative rate may be higher with interleukin (IL)-17 inhibitors than with other biologics.

METHODOLOGY:

• Researchers conducted a systematic review of pharmacovigilance studies on biologic therapies for psoriasis.
• They evaluated 10 studies, published from 2014 to 2023, which included 189,103 cases, focusing on GI-related AE reports associated with biologics used to treat psoriasis.
• Reporting odds ratios (RORs) were used in the studies to estimate relative risk for a particular AE reported for a specific drug compared with all other drugs.
• The mean age of participants was 48.6 years; 56.1% were women.

TAKEAWAY:

• Of the 189,046 AE reports for biologics used to treat psoriasis, 16,470 (8.7%) were GI-related.
• Biologics associated with any GI-related AE reports included IL-17, IL-23, and antitumor necrosis factor alpha agents, with pooled RORs of 0.76, 0.44, and 0.41, respectively.
• The highest pooled RORs for specific GI-related AEs included rectal adenocarcinoma (ROR, 16.99; absolute risk [AR], 0.03%), eosinophilic esophagitis (ROR, 9.8; AR, 0.03%), and diverticular perforation (ROR, 4.19; AR, 0.03%) with guselkumab. RORs for inflammatory bowel disease (IBD) were higher for secukinumab and ixekizumab (ROR, 2.79-11.1; AR. 1.6%). ROR for irritable bowel syndrome with secukinumab was 3.56 (AR, 0.3%).
• The mean latency for GI events was 75.5 days (range, 20-280 days), and 16 deaths (0.1%) with a GI etiology were reported, predominantly IBD (n = 13).

IN PRACTICE:

The pooled RORs and the 8.7% incidence in the review “suggest GI events occur similarly to clinical trials; however, IL-17 inhibitors may have a higher relative rate than other biologics,” the authors wrote. “Future studies are warranted to evaluate increased GI safety signals identified with individual biologics,” they said.

SOURCE:

The study was led by Siddhartha Sood, HBSc, University of Toronto, Toronto, Ontario, Canada, and was published online on September 20 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The study’s limitations included statistical heterogeneity, the variety of indications for biologics, and incomplete and potentially biased AE reporting, which may affect the generalizability and reliability of the findings.

DISCLOSURES:

The study did not receive any funding. Two authors reported being advisors, consultants, speakers, and/or investigators for multiple pharmaceutical companies, including AbbVie, Amgen, and Janssen.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.