IL-17 Inhibitors Increase Risk of Candida and Fungal Infections in Psoriasis Patients: Study

Meta-analysis indicated that compared with placebo, interleukin-17 (IL-17) inhibitors notably raised the risk of Candida infections (OR = 2.39, 95% CI = 1.84–3.11, p < 0.00001), whereas tumour necrosis factor-alpha (TNF-α) inhibitors (OR = 1.75, 95% CI = 0.53–5.82, p = 0.36) and interleukin-12/23 (IL-12/23) inhibitors (OR = 1.11, 95% CI = 0.27–4.63, p = 0.88) showed no significant differences. Cross-comparison demonstrated that IL-17 inhibitors had a higher risk of Candida infection compared to TNF-α inhibitors (OR = 2.23, 95% CI = 1.08–4.57, p = 0.03) and IL-12/23 inhibitors (OR = 4.21, 95% CI = 2.71–6.55, p < 0.00001). For dermatophyte infections, the overall risk associated with biologic agents was increased (OR = 1.89, 95% CI = 1.19–3.01, p = 0.007), IL-17 inhibitors showed a higher risk compared to IL-12/23 inhibitors (OR = 2.70 95% CI = 1.29–5.63, p = 0.008). Overall, biologic agents significantly increased the risk of superficial fungal infections compared to placebo (OR = 2.10, 95% CI = 1.73–2.55, p < 0.00001). Biologic agents, particularly IL-17 inhibitors, notably increase the risk of superficial fungal infections in psoriasis patients.

In clinical practice, targeted monitoring protocols should be established, including regular follow-up to promptly detect superficial fungal infections and initiate antifungal treatment as necessary.

Reference:

H. Liu, L. Zhou, Z. Song, R. Zhang, and Y. Kang, “ Biologic Therapy and Superficial Fungal Infection Risk in Moderate-to-Severe Psoriasis: A Meta-Analysis,” Mycoses 68, no. 6 (2025): e70081, https://doi.org/10.1111/myc.70081.