Key clinical point: The risk for infections in patients with psoriatic arthritis (PsA) did not increase with most biologic and small-molecule therapies, except bimekizumab, apremilast, and 30 mg upadacitinib.
Major finding: In patients with PsA, bimekizumab (relative risk [RR] 14.23; 95% CI 1.97-102.60), apremilast (RR 1.41; 95% CI 1.08-1.83) and 30 mg upadacitinib (RR 1.37; 95% CI 1.05-1.80) led to a significantly higher risk of infections compared to placebo, with 30 mg upadacitinib vs placebo also increasing the risk for serious infections (RR 3.66; 95% CI 1.43-9.38).
Study details: Findings are from a network meta-analysis of 94 randomized controlled trials including 54,369 patients with PsA or psoriasis who were treated with 14 biologics, five small molecules, or placebo.
Disclosures: This study was partly funded by grants from the National Taiwan University Hospital and Chang Gung Memorial Hospital. HY Chiu and YH Huang declared receiving speaking fees or honoraria from, serving as principal investigator for, or having other ties with various sources.
Source: Chiu HY et al. Comparative short-term risks of infection and serious infection in patients receiving biologic and small-molecule therapies for psoriasis and psoriatic arthritis: A systemic review and network meta-analysis of randomized controlled trials. Ther Adv Chronic Dis. 2023;14:20406223231206225. (Oct 27). doi: 10.1177/20406223231206225