Comparative Safety of IL-17 vs IL-23 Inhibitors in Psoriasis: A TriNetX Cohort Study Supplemental Analyses
Description
IL-17 inhibitors and Il-23 inhibitors are separately compared to both TNF-α inhibitors and ustekinumab to contextualize risk.
Files
Steps to reproduce
Using the TriNetX Research Network (>115 healthcare organizations; run August 18, 2026), we performed a retrospective cohort study of adults with ≥2 psoriasis diagnoses who initiated an IL-17, IL-23, or TNF-α inhibitors or ustekinumab on or after January 1, 2019. Patients with prior candidiasis, tinea, or IBD diagnoses were excluded, as were patients with exposure at any time to inhibitors of the opposing cohorts or candidal sepsis. Cohorts were propensity score matched (1:1) for demographics, comorbidities (neoplasms, diabetes, chronic kidney disease, psoriatic arthritis), smoking, prior photochemotherapy/PUVA, and methotrexate use. Outcomes included mucosal candidiasis, cutaneous candidiasis, tinea, IBD, URI, headache, and composite adverse events (AEs) within 3 years of initial prescription and were reported as hazard ratios (HRs) with 95% confidence intervals estimated by Cox proportional-hazards models with Bonferroni correction.