PDF(Pubmed)
Abstract：
Targeted therapies represent major advancements in the treatment of chronic skin conditions such as psoriasis. While previous studies have shown an increased risk of melanoma and non-melanoma skin cancer (NMSC) in patients receiving TNF-α inhibitors, the risks associated with newer biologics (IL-12/23 inhibitors, IL-23 inhibitors, IL-17 inhibitors) and Janus kinase (JAK) inhibitors remain less known. Using a systematic and meta-analytical approach, we aimed to summarize the currently available literature concerning skin cancer risk in patients treated with targeted therapies. The MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to find studies reporting the incidence rates (IR) of melanoma and NMSC in patients with psoriasis and psoriatic arthritis treated with biologics or JAK inhibitors. Nineteen studies were included in the analysis with a total of 13,739 patients. The overall IR of melanoma was 0.08 (95% CI, 0.05-0.15) events per 100 PYs and the overall IR of NMSC was 0.45 (95% CI, 0.33-0.61) events per 100 PYs. The IRs of melanoma were comparable across patients treated with IL-17 inhibitors, IL-23 inhibitors, and JAK inhibitors, while the IRs of NMSC were higher in patients treated with JAK inhibitors than in those treated with biologics. Prospective, long-term cohort studies are required to reliably assess the risks associated with novel targeted therapies.
摘要：
靶向疗法代表了治疗慢性皮肤病如牛皮癣的主要进步。虽然以前的研究表明，接受TNF-α抑制剂的患者患黑色素瘤和非黑色素瘤皮肤癌（NMSC）的风险增加，与新型生物制剂相关的风险(IL-12/23抑制剂，IL-23抑制剂，IL-17抑制剂）和Janus激酶（JAK）抑制剂仍然鲜为人知。使用系统和元分析方法，我们旨在总结目前可获得的有关靶向治疗患者皮肤癌风险的文献.MEDLINE/PubMed,EMBASE,WebofScience,我们搜索了CochraneLibrary数据库,以发现报告使用生物制剂或JAK抑制剂治疗的银屑病和银屑病关节炎患者中黑色素瘤和NMSC发病率(IR)的研究.19项研究被纳入分析，共有13,739名患者。黑色素瘤的总IR为每100个PYs0.08(95%CI,0.05-0.15)个事件,且NMSC的总IR为每100个PYs0.45(95%CI,0.33-0.61)个事件。黑色素瘤的IR在接受IL-17抑制剂治疗的患者中具有可比性，IL-23抑制剂，和JAK抑制剂，而使用JAK抑制剂治疗的患者的NMSC的IRs高于使用生物制剂治疗的患者。前瞻性,需要进行长期队列研究,以可靠地评估与新型靶向治疗相关的风险.
