Biological treatment for psoriasis and the risk of herpes zoster: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

Guy Shalom, Luigi Naldi, Mark Lebwohl, Arjen Nikkels, Elke M.G.J. de Jong, Steven Fakharzadeh, Kavitha G. Goyal, Bhaskar Srivastava, Wayne Langholff, Claudia Galindo, Arnon D. Cohen

    Research output: Contribution to journalArticlepeer-review

    14 Scopus citations

    Abstract

    Purpose: To describe the risk of herpes zoster (HZ) in patients with psoriasis and its relation to non-biologic systemic therapies or biologic treatment. Materials and methods: Psoriasis Longitudinal Assessment and Registry (PSOLAR) is an international, prospective, registry that follows adult patients with psoriasis eligible to receive non-biologic systemic therapies or biologic therapies. Mutually exclusive therapy cohorts were defined. HZ incident rates were calculated for each therapy cohort and rates between cohorts were compared using hazard ratios (HR) adjusted for potential confounders, in new users and prevalent-exposure patients. Results: A total of 55 HZ events were identified in 10,469 patients in PSOLAR. The adjusted hazard ratio in the overall study population (new user and prevalent-exposed patients) was 2.22 (95% CI: 0.82–5.97; p =.116) for tumor necrosis factor-α (TNF) inhibitors, 2.73 (0.98–7.58; p =.054) for ustekinumab, and 1.04 (0.20–5.41; p =.966) for methotrexate versus reference (combined phototherapy, systemic steroids, topical therapy, and immunomodulators other than methotrexate). Conclusions: Exposure to ustekinumab, TNF-α inhibitors, and methotrexate was not associated with a statistically significant increased risk of HZ. However, HRs were elevated for ustekinumab and TNF-α inhibitors; a larger number of HZ events would be needed to assess the presence or absence of risk.

    Original languageEnglish
    Pages (from-to)534-539
    Number of pages6
    JournalJournal of Dermatological Treatment
    Volume30
    Issue number6
    DOIs
    StatePublished - 18 Aug 2019

    Keywords

    • Biologics
    • PSOLAR
    • herpes zoster
    • psoriasis
    • tumor necrosis factor

    ASJC Scopus subject areas

    • Dermatology

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