Patients with psoriasis who start treatment with apremilast, etanercept or ustekinumab have a lower risk of developing a serious infection than those prescribed methotrexate, a study shows.

US researchers used two insurance claims databases to identify more than 107,000 patients with psoriasis newly prescribed acitretin, adalimumab, apremilast, etanercept, infliximab, methotrexate or ustekinumab between 2003 and 2015.

Analysis showed significantly lower risks of serious infection overall with apremilast (50% less risk), etanercept (25% less) and ustekinumab (35% less) compared with methotrexate.

The risk of serious infection with acitretin, adalimumab and infliximab was similar to that with methotrexate.