More research is needed to better understand the pathophysiologic mechanisms that result in increased risk for infection among individuals with psoriasis.
Infectious disease is a common comorbidity in patients with psoriasis, and rates of skin, respiratory, and abdominal infections are especially high in this population.1 Among individuals receiving treatment for moderate to severe psoriasis, infection has been identified as the second leading cause of death.
Multiple studies have explored immunosuppressive therapies as a potential causative factor. A multicenter longitudinal study based on data from the Psoriasis Longitudinal Assessment and Registry examined the risk for serious infection in 11,466 adults receiving biologic or systemic therapies for psoriasis.2 Patients were followed for up to 8 years.
The overall rate of infections was 1.45 per 100 patient-years (n=323), with varying rates across treatments: ustekinumab (0.83), etanercept (1.47), adalimumab (1.97), infliximab (2.49), non-methotrexate/nonbiologics (1.05), and methotrexate/nonbiologics (1.28). Pneumonia and cellulitis were the most common types of infections among registry participants, and the authors concluded that risk factors for increased infection included older age, smoking, diabetes, infection history, and exposure to infliximab and adalimumab.
|Read on: Managing Infection Risk in Psoriasis: Expert Q&A|