Biologics Linked to Lower Infection Risk in Older Psoriatic Patients: Study

Biologics targeting interleukin (IL)-12, IL-23, and IL-17 were associated with lower rates of serious infection in older adults with psoriatic disease, according to a cohort study using Ontario health data.

The study, published in JAMA Dermatology, looked at outcomes for 11,641 Ontario residents aged 66 years or older who began systemic treatments for psoriatic disease between 2002 and 2020. Researchers followed subjects for a median of 4.8 years, during which time there were 1,967 serious infections leading to hospitalization.

According to the study results, rates of serious infection varied by treatment type. Tofacitinib was associated with the highest rate of serious infections (8.9 per 100 person-years). Biologics targeting IL-12, IL-23, and IL-17 had the lowest rate (1.4 per 100 person-years). Methotrexate, older systemic medications, and anti–tumor necrosis factor (anti-TNF) biologics yielded intermediate rates (ranging from 2.2 to 2.7 per 100 person-years). In multivariable analyses, biologics targeting IL pathways were associated with a 35% lower risk of serious infections (RR = 0.65; 95% CI, 0.48 to 0.88) vs. periods of no biologic treatment. Tofacitinib was linked with significantly increased risk of serious infections (RR = 2.89; 95% CI, 1.14 to 7.34).

"In this cohort study, biologics targeting IL-12, IL-23, or IL-17 were associated with a lower rate of serious infection among older adults with psoriatic disease," the authors wrote. "These biologics may have important safety benefits for older adults with higher infection risk."

Source: Drucker A, et al. JAMA Dermatology. 2025. Doi:10.1001/jamadermatol.2025.0144