IL-17 inhibitors carry the candidiasis risk and TNF inhibitors the TB, in 118,000 person-years of psoriasis treatment

The edition in brief

Five findings for dermatologists. In the British BADBIR register (18,635 patients, 118,018 person-years), tuberculosis (0.19 per 1,000 person-years) and meningitis (0.25) were rare and mostly followed TNF inhibitors, particularly adalimumab; IL-17 inhibitors carried 2.7 to 4.7 times the candidiasis risk of every other systemic class. A phase 2 trial of the IL-36 receptor antibody recibokibart in 33 patients with acute generalised pustular psoriasis flares found 86.4% reached a pustulation score of 0 or 1 at day 8 versus 9.1% with placebo. A Delphi panel of 31 US experts agreed oral JAK inhibitors are the primary long-term therapy for severe alopecia areata, with dupilumab an alternative in atopic patients. An 860-patient Italian real-world cohort found topical ruxolitinib achieved F-VASI75 in 18.5% at 24 weeks and 38.4% at 52 weeks in vitiligo, with anxiety falling alongside repigmentation. A meta-analysis of 25 studies found hidradenitis suppurativa was associated with 1.3- to 1.8-fold risks of coronary disease, myocardial infarction, heart failure, venous thromboembolism and death, though with low certainty.