Safety Profile of Systemic Therapy for the Management of Psoriasis in Patients With Diabetes Mellitus: Data From the BIOBADADERM Prospective Cohort.
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Lluch-Galcerá J J, Carrascosa J M, González-Quesada A, Sahuquillo A, Rivera Díaz R, Llamas-Velasco M, Herrera-Acosta E, Belinchón I, Gómez García F J, Baniandrés-Rodríguez O, Ruiz-Genao D P, López-Estebaranz J L, Rodríguez Fernández-Freire L, de la Cueva Dobao P, Ferrán Farrés M, Mateu Puchades A, Ruiz-Villaverde R, Riera-Monroig J, Ara-Martín M, Roncero Riesco M, Gracia-Cazaña T, Abalde Pintos M T, Pujol Marco C, García-Donoso C, Del Alcázar E, Santamaría C, Suárez Pérez J, Rodríguez Sánchez B, Díez-Madueño K, Lezcano Biosca V, Morales Callaghan A M, Salgado-Boquete L, Montes-Torres A, González-Sixto B, Descalzo M Á, García-Doval I
Аннотация
METHODS: We conducted a prospective cohort study using data from the BIOBADADERM registry. We calculated incidence rates (IRs) of DM-AEs for each systemic treatment class, including biologics (tumor necrosis factor [TNF] inhibitors, interleukin [IL]-12/23 inhibitors, IL-17 inhibitors, and IL-23 inhibitors), conventional systemic therapies (methotrexate [MTX], cyclosporine, and acitretin), and apremilast (APR). The primary outcome was the adjusted incidence rate ratio (aIRR) for DM-AEs comparing patients receiving MTX with those receiving other systemic therapies using Poisson regression models adjusted for potential confounders.
RESULTS: The study included 732 patients, 1401 treatment cycles, and 2865 person-years (PYs) of follow-up. APR (aIRR, 0.30; 95% CI, 0.10-0.60) was associated with a significantly lower risk of DM-AEs compared with MTX. Cyclosporine (aIRR, 7.50; 95% CI, 3.30-17.30) and acitretin (aIRR, 2.10; 95% CI, 1.20-3.70) were associated with a higher risk compared with MTX.
CONCLUSIONS: Among patients with psoriasis and DM, APR was associated with a lower incidence of DM-AEs, whereas cyclosporine and acitretin were associated with higher incidences compared with MTX.