Is there an increased risk of cancer with biologic treatments compared to systemic treatments?

Is there an increased risk of cancer with biologic treatments compared to systemic treatments?


Hi, my name is Shamarke Esse. I’m currently in the first year of a three year doctoral research programme at the University of Manchester. My supervisors are Professor Richard Warren, Professor Adele Green and Dr Kayleigh Mason. For approximately 20-30% of people with psoriasis, topical treatments are ineffective and plaques end up covering at least 10% of the skin’s surface. These people can be offered phototherapy
which involves exposing the skin to ultraviolet light with the aim of slowing down the rapid growth of skin cells. Ultimately they may try treatments that directly target the immune system; namely conventional systemic drugs or biologics. Conventional systemic drugs act by decreasing the overall effect of the immune system in a bid to stop it from producing the extra skin cells that build up to form the plaques. Biologic drugs are a bit different as they target specific parts of the immune system
that are thought to be responsible for the condition rather than the whole immune system. Although these types of drugs are proven to be effective, they might, in theory, come with a cost. As the immune system plays an important role in our body’s ability to fight off cancer, dampening or blocking parts of it could alter the risk of cancer development. I should emphasise at this point that we don’t necessarily think that this is the case. My research project involves comparing people with psoriasis who’ve been treated with only the conventional systemic treatments to those who have been treated with the biologics. This will help us to work out whether biologics increase the risk of cancer in people receiving
these treatments. The British Association of Dermatologists
Biologic Interventions Register (BADBIR) is a study tracking over 15500 people with psoriasis
being treated with conventional systemic drugs or biologics at 157 centres in the UK and
Ireland. This will allow me to track the number of people that develop cancer after treatment
over a long period of time. Using this data I will calculate the risk of cancer for each treatment and what types of cancers are likely to develop. So this research is really important as it provides people with psoriasis and their clinicians with high quality evidence about the risk of cancer development when using biologic treatments versus conventional systemic treatments. These results will inform the care of these
people and will also empower them to make more informed choices about their treatment for psoriasis.

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