Clinically effective treatment with biologic agents is associated with reduced coronary artery diseases in patients with severe psoriasis, according to the results of a recent four-year study, published in JAMA Dermatology .1
Due to accelerated coronary artery disease, inflammatory pathways of psoriasis share connections with the mechanisms of atherosclerosis as well as the association between psoriasis and cardiovascular disease.
Patients with severe psoriasis were enrolled in the single-center prospective, controlled, observer-blinded clinical study. Between April 11, 2011, through June 30, 2014, biological therapy (intervention group) and a matched control that did not receive the same therapy (control group) were initiated. Biological therapy for psoriasis included adalimumab, etanercept, infliximab, ustekinumab, along with the possibility to switch between treatments to ensure inflammation control.
At the baseline and with 13 months of follow-up, 28 treated patients (mean [SD] age, 49.2 [10.2] years; 71% men; mean [SD] Psoriasis Area Severity Index [PASI], 15.4 [4.3]) and 28 controls (mean [SD] age, 52.8 [10.6] years; 71% men; mean [SD] PASI, 12.4 [3.9]) underwent noncontrast coronary artery calcium (CAC) CT and contrast-enhanced coronary CT angiography. Changes in CAC score, number of coronary plaques, severity of narrowing, composition, and vessel wall volume were measured.
In the intervention group, the CAC scores remained stable and progressed in the control group (mean [SD] yearly CAC change, -16 [56]; P = .15 vs. 14 [29]; P = .02). The severity of luminal narrowing in the diseased segments remained unchanged in the intervention group but increased at follow-up in the control group (Wilcoxon W=76, n=483, P=.39 vs Wilcoxon W=281, n= 414, P = .02). Luminal abnormalities remained unchanged in both groups. In addition, automated vessel wall volume index in the intervention group remained unchanged from baseline to follow-up, compared to the control group, which demonstrated nonsignificant progressions (mean [SD] baseline, 7.1 [1.5], follow-up, 7.1 [1.7]; P = .91 vs baseline, 8.3 [1.6], follow-up, 8.9 [2.2]; P = .06).
Although the effect of anti-inflammatory drugs on the development of coronary atherosclerosis remains unknown, the findings of the study support a beneficial effect of biologic anti-inflammatory agents, which can prevent cardiovascular disease progression and disease control in inflammatory diseases in patients with severe psoriasis.
Reference
- Hjuler KF, Bottcher M, Vestergaard C, Botker HE, Iversen L, Kragalle K. Association Between Changes in Coronary Artery Disease Progression and Treatment With Biologic Agents for Severe Psoriasis [published online ahead of print July 7, 2016]. JAMA Dermatol. doi: 10.1001/jamadermatol.2016.1984
Clinically effective treatment with biologic agents is associated with reduced coronary artery diseases in patients with severe psoriasis, according to the results of a recent four-year study, published in JAMA Dermatology .1
Due to accelerated coronary artery disease, inflammatory pathways of psoriasis share connections with the mechanisms of atherosclerosis as well as the association between psoriasis and cardiovascular disease.
Patients with severe psoriasis were enrolled in the single-center prospective, controlled, observer-blinded clinical study. Between April 11, 2011, through June 30, 2014, biological therapy (intervention group) and a matched control that did not receive the same therapy (control group) were initiated. Biological therapy for psoriasis included adalimumab, etanercept, infliximab, ustekinumab, along with the possibility to switch between treatments to ensure inflammation control.
At the baseline and with 13 months of follow-up, 28 treated patients (mean [SD] age, 49.2 [10.2] years; 71% men; mean [SD] Psoriasis Area Severity Index [PASI], 15.4 [4.3]) and 28 controls (mean [SD] age, 52.8 [10.6] years; 71% men; mean [SD] PASI, 12.4 [3.9]) underwent noncontrast coronary artery calcium (CAC) CT and contrast-enhanced coronary CT angiography. Changes in CAC score, number of coronary plaques, severity of narrowing, composition, and vessel wall volume were measured.
In the intervention group, the CAC scores remained stable and progressed in the control group (mean [SD] yearly CAC change, -16 [56]; P = .15 vs. 14 [29]; P = .02). The severity of luminal narrowing in the diseased segments remained unchanged in the intervention group but increased at follow-up in the control group (Wilcoxon W=76, n=483, P=.39 vs Wilcoxon W=281, n= 414, P = .02). Luminal abnormalities remained unchanged in both groups. In addition, automated vessel wall volume index in the intervention group remained unchanged from baseline to follow-up, compared to the control group, which demonstrated nonsignificant progressions (mean [SD] baseline, 7.1 [1.5], follow-up, 7.1 [1.7]; P = .91 vs baseline, 8.3 [1.6], follow-up, 8.9 [2.2]; P = .06).
Although the effect of anti-inflammatory drugs on the development of coronary atherosclerosis remains unknown, the findings of the study support a beneficial effect of biologic anti-inflammatory agents, which can prevent cardiovascular disease progression and disease control in inflammatory diseases in patients with severe psoriasis.
Reference
- Hjuler KF, Bottcher M, Vestergaard C, Botker HE, Iversen L, Kragalle K. Association Between Changes in Coronary Artery Disease Progression and Treatment With Biologic Agents for Severe Psoriasis [published online ahead of print July 7, 2016]. JAMA Dermatol. doi: 10.1001/jamadermatol.2016.1984
Clinically effective treatment with biologic agents is associated with reduced coronary artery diseases in patients with severe psoriasis, according to the results of a recent four-year study, published in JAMA Dermatology .1
Due to accelerated coronary artery disease, inflammatory pathways of psoriasis share connections with the mechanisms of atherosclerosis as well as the association between psoriasis and cardiovascular disease.
Patients with severe psoriasis were enrolled in the single-center prospective, controlled, observer-blinded clinical study. Between April 11, 2011, through June 30, 2014, biological therapy (intervention group) and a matched control that did not receive the same therapy (control group) were initiated. Biological therapy for psoriasis included adalimumab, etanercept, infliximab, ustekinumab, along with the possibility to switch between treatments to ensure inflammation control.
At the baseline and with 13 months of follow-up, 28 treated patients (mean [SD] age, 49.2 [10.2] years; 71% men; mean [SD] Psoriasis Area Severity Index [PASI], 15.4 [4.3]) and 28 controls (mean [SD] age, 52.8 [10.6] years; 71% men; mean [SD] PASI, 12.4 [3.9]) underwent noncontrast coronary artery calcium (CAC) CT and contrast-enhanced coronary CT angiography. Changes in CAC score, number of coronary plaques, severity of narrowing, composition, and vessel wall volume were measured.
In the intervention group, the CAC scores remained stable and progressed in the control group (mean [SD] yearly CAC change, -16 [56]; P = .15 vs. 14 [29]; P = .02). The severity of luminal narrowing in the diseased segments remained unchanged in the intervention group but increased at follow-up in the control group (Wilcoxon W=76, n=483, P=.39 vs Wilcoxon W=281, n= 414, P = .02). Luminal abnormalities remained unchanged in both groups. In addition, automated vessel wall volume index in the intervention group remained unchanged from baseline to follow-up, compared to the control group, which demonstrated nonsignificant progressions (mean [SD] baseline, 7.1 [1.5], follow-up, 7.1 [1.7]; P = .91 vs baseline, 8.3 [1.6], follow-up, 8.9 [2.2]; P = .06).
Although the effect of anti-inflammatory drugs on the development of coronary atherosclerosis remains unknown, the findings of the study support a beneficial effect of biologic anti-inflammatory agents, which can prevent cardiovascular disease progression and disease control in inflammatory diseases in patients with severe psoriasis.
Reference
- Hjuler KF, Bottcher M, Vestergaard C, Botker HE, Iversen L, Kragalle K. Association Between Changes in Coronary Artery Disease Progression and Treatment With Biologic Agents for Severe Psoriasis [published online ahead of print July 7, 2016]. JAMA Dermatol. doi: 10.1001/jamadermatol.2016.1984
