Recent findings provide strong reassurance for dermatologists managing chronic psoriatic disease: long-term use of ixekizumab (Taltz®) is not associated with increased risk of malignancy. With follow-up extending to five years in clinical trials, comprehensive safety data show stable incidence rates of cancer, even slightly lower than in the general population. This evidence supports continued, confident use of ixekizumab in long-term treatment plans.
Extensive Data Support Safety Profile
A pooled analysis of 25 randomized trials involving nearly 7,000 patients with psoriasis, psoriatic arthritis, and ankylosing spondylitis revealed reassuring malignancy data after up to six years of follow-up. Age and sex-adjusted incidence ratios for all cancers remained at or below standard population levels, with no upward trend observed over time. Notably, the incidence of nonmelanoma skin cancers (NMSC), including basal cell carcinoma and squamous cell carcinoma, was comparable to baseline expectations, while melanoma cases remained rare.
An updated meta-analysis of long-term extension studies further confirmed these trends, showing malignancy incidence at or below 0.58 per 100 patient-years through 156 weeks of ixekizumab exposure. Importantly, the rate of cancer did not increase over time, reinforcing the long-term safety of IL‑17A inhibition.
Clinical Implications for Dermatology Practice
These comprehensive safety insights provide a foundation for dermatologists to prescribe ixekizumab with confidence in its long-term risk profile. Key clinical takeaways include:
Reassurance for patients and providers
The data support long-term use without elevated malignancy risk, a crucial consideration for chronic disease management.
Continued safety monitoring
While findings are strongly reassuring, standard cancer surveillance, especially for NMSC, remains recommended.
Treatment decisions remade
In patients with prior malignancy or cancer risk factors, ixekizumab emerged as a viable biologic choice, offering effective control without added cancer concerns.
Ixekizumab in Context: Beyond Cancer Risk
Though malignancy risk is low, other long-term considerations include infection, inflammatory bowel disease (IBD), and hypersensitivity events, each appearing stable and manageable over time. Importantly, no increase in opportunistic infections or serious adverse events has been linked to extended ixekizumab use.
When compared to TNF inhibitors, IL‑17A inhibitors like ixekizumab may actually show lower malignancy rates in some studies, although more real-world evidence is needed.
Conclusion
For dermatologists seeking durable, safe, biologic options, ixekizumab stands out as a leading choice. With malignancy risk at baseline population levels, even after years of use, it empowers clinicians and patients to prioritize long-term skin and joint health without fear of cancer-associated adverse events.
Moving forward, this safety profile should support broader confidence in selecting ixekizumab for appropriate patients and encourage consistent follow-up and monitoring to maintain optimal outcomes.
Sources:
