IL-17 inhibitors carried three to five times the candidiasis risk in 18,635 psoriasis patients

The edition in brief

In 18,635 adults with psoriasis on systemic treatment in the British BADBIR register (118,018 person-years), tuberculosis and meningitis were rare (0.19 and 0.25 per 1,000 person-years), with most cases on TNF inhibitors, especially adalimumab. Fungal infection was much more common (7.5 per 1,000 person-years), and IL-17 inhibitors carried a higher candidiasis risk than every other group, with rate ratios from 2.67 against apremilast to 4.65 against IL-12/23 inhibitors. TB rates will be far higher in India, so screening and vigilance matter more here. A Delphi consensus of 49 experts from nine countries supports low-dose oral minoxidil in children aged 4 to under 12 with several non-scarring hair disorders, gives weight-band and mg/kg starting doses, and names pericardial effusion and phaeochromocytoma as contraindications. In the PEDISTAD registry of 500 children under 12 with moderate-to-severe eczema, dupilumab produced the largest observed improvement in both White and non-White children, ahead of methotrexate and ciclosporin. A 170-patient US trial found a native collagen matrix with PHMB added to standard care raised 12-week closure of hard-to-heal diabetic foot ulcers from 27% to 42%, with a confidence interval that only just excluded no effect.