Could Psoriasis Treatment Improve Aortic Vascular Inflammation?

Improving psoriasis symptoms may help improve aortic vascular inflammation after 1 year of treatment, according to a recent study.

Inflammation is a key factor in developing atherosclerosis. Therefore, the researchers aimed to better understand the connection between chronic inflammatory psoriasis and cardiovascular health.
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Between January 1, 2013, and October 31, 2016, 220 patients with psoriasis from outpatient practices were recruited at the National Institutes of Health. The researchers had followed up with 115 consecutively recruited patients after 1 year.

Psoriasis Area and Severity Index (PASI) scores were used to measure skin inflammation, and vascular inflammation was assessed using target-to-background ratio by ¹⁸fluorodeoxyglucose positron emission tomography/computed tomography.

Overall, the mean age at 1-year follow-up was 50.8 years, and the majority of participants were men (59%). Participants had a low cardiovascular risk, as assessed by the Framingham risk score, and had mild to moderate psoriasis, with a median PASI score of 5.2.

Analysis after follow-up showed an overall median improvement in PASI score of 33%. Topical therapy (60%), biological therapy (66%, mostly anti-tumor necrosis factor), and phototherapy (15%) improved symptoms the most.

Results also indicated that improvement in PASI score was linked to improvement in a target-to-background ratio of 6%, mainly driven by those with higher responses in PASI score. The researchers noted that this association persisted beyond traditional risk factors and was the strongest in those initiated with anti-tumor necrosis factor therapy.

“Improvement in psoriasis skin disease severity was associated with improvement in aortic vascular inflammation by ¹⁸fluorodeoxyglucose positron emission tomography/computed tomography, with greater improvement in aortic vascular inflammation observed in those who had higher than 75% reduction in skin disease severity,” the researchers concluded. “These findings suggest that controlling remote target organ inflammation (eg, in the skin) may improve vascular diseases; however, randomized clinical trials are needed to confirm these findings.”

—Christina Vogt

Reference:

Dey AK, Joshi AA, Chaturvedi, et al. Association between skin and aortic vascular inflammation in patients with psoriasis: a case-cohort study using positron emission tomography/computed tomography. JAMA Cardiol. Published online May 31, 2017. doi:10.1001/jamacardio.2017.1213.