Psoriasis Treatments Linked to Varying Risks of Infection, Study Finds - Video

Tuberculosis and meningitis were rare among people receiving systemic treatments for psoriasis, while candidiasis was more common among those treated with IL-17 inhibitors, according to a study published in the British Journal of Dermatology.

The study included 18,635 adults with psoriasis who underwent 40,930 treatment episodes between 2007 and 2024. Together, these treatment episodes provided 118,018 person-years of follow-up. Patients were followed from the start of treatment until treatment discontinuation, death or the end of available follow-up.

Researchers assessed cases of tuberculosis, meningitis, candidiasis and other fungal infections and compared infection rates across different treatments. During follow-up, 22 cases of tuberculosis, 29 cases of meningitis and 888 fungal infections were reported. Of the fungal infections, 450 were cases of candidiasis. The incidence was 0.19 cases of tuberculosis per 1,000 person-years, 0.25 cases of meningitis and 7.53 cases of fungal infections.

Most tuberculosis and meningitis cases occurred among patients receiving tumour necrosis factor-alpha inhibitors. Tuberculosis was mainly pulmonary, while meningitis was mostly viral. Fewer than five meningitis cases were followed by death within 30 days.

In contrast, patients receiving IL-17 inhibitors had a higher risk of candidiasis compared with patients receiving other systemic treatments. The risk was between 2.67 and 4.65 times higher, depending on which treatment group was used for comparison.

The study did not find significant differences between individual IL-17 inhibitors in the risk of candidiasis. There were also no significant differences between treatment groups for fungal infections other than candidiasis.

Researchers said the findings show that different treatments have different infection patterns. While tuberculosis and meningitis remained uncommon, candidiasis and other fungal infections occurred more frequently. They also noted that longer follow-up will be needed to better understand the risks of newer treatments, particularly rare infections.

REFERENCE: Bright H B B et al. Risks of tuberculosis, meningitis, candidiasis, and fungal infections among patients receiving systemic treatments for psoriasis: a nationwide cohort study from BADBIR data, British Journal of Dermatology, 2026;, ljag397, https://doi.org/10.1093/bjd/ljag397