What biologic for psoriasis do you prescribe most often in patients with a history of malignancy?
I like an IL-17 inhibitor for psoriasis with a current or history of malignancy. IL-17 is involved with cancer neoangiogenesis, so blocking it may have an anti-tumor effect. This hasn’t been studied yet but it makes me feel better that the IL-17 class doesn’t have an increased risk of cancer and may...
I think this needs to be done as part of shared decision-making. I am generally comfortable with all biologics in those with solid organ malignancy. I prefer IL-23s in those with lymphoma because IL-23s can induce remission. So I will give the loading dose and then dose the patient on demand. I alwa...
I tend to go with the IL-23 inhibitors in patients with a history of malignancy, specifically because IL-23 has been associated with tumor progression in multiple animal models.
An interesting finding was that this seems to be rather independent of the IL-17A pathway (Teng et al., PMID 20404142), and...