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CARDIOVASCULAR DISEASE
Psoriasis biologics may help reduce coronary plaque
Medical writer: Kirsty LEE | Last updated: 8th October 2020 | In: AutoImmune Disorders, Cardiovascular
Article Keywords
adalimumab, anti-IL-12, anti-IL-23, anti-TNF, CAD, cardiovascular disease, CCTA, coronary artery disease, coronary computed tomography angiography, coronary plaque, CVD, etanercept, Framingham Risk Score, ixekizumab, psoriasis, secukinumab, ustekinumab
Psoriasis is an immune-mediated chronic inflammatory skin disorder that presents with plaques on the skin, and is associated with an increased prevalence of cardiovascular (CV) risk factors and CV disease (CVD).1Manolis AA et al. Int Rev Immunol. 2019;38(1):33-54. A meta-analysis has found that patients with psoriasis have a higher prevalence of subclinical coronary artery disease (CAD), and more high-risk coronary plaques, compared with control patients without psoriasis.2Kaiser H et al. Dermatol Basel Switz. 2019;235(6):478-487. Psoriasis is often treated with biologic therapy, including anti-TNF, anti-IL/12/23 or anti-IL-17 inhibitors.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. Inflammation is also critical in the progression of CAD.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. Biologic therapies for psoriasis have been associated with an improvement in non-calcified coronary plaque burden.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199.
A recently published study characterised the lipid-rich necrotic core (LRNC) in psoriasis and how LRNC modulates in response to biologic therapy.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. The study utilised a histopathologically validated imaging application on coronary computed tomography angiography (CCTA) images characterising LRNC in the coronary arteries before and after the initiation of biologic therapy in patients over one year.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199.
A total of 209 consecutive biologic-naïve psoriasis patients with baseline and 1-year CCTA scans for analysis were included in this study.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. Biologic therapies for psoriasis included adalimumab, etanercept, ustekinumab, ixekizumab, and secukinumab.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. Patients who chose not to receive biologic therapy at the baseline visit were used as a reference group and were treated with topical, UV, and systemic therapies.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199.
Study participants were middle-aged and predominantly male, with a low cardiovascular risk and mild-to-moderate psoriasis skin disease.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. At 1-year follow-up, patients who had initiated biologic therapy had a decrease in LRNC area (3.12mm2 at baseline vs 2.97mm2; p=0.028).3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. In contrast, patients who had not received biologic therapy over the one year demonstrated no significant change in LRNC from baseline.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. The LRNC change over once year between the biologic and non-biologic groups were significant, even after adjustment for psoriasis severity, Framingham risk score, body mass index, and statin use.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199. LRNC reductions continued to be significant compared to the non-biologic patients when stratifying by class of biologic.3Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199.
Reference
- Manolis AA et al. Int Rev Immunol. 2019;38(1):33-54.
- Kaiser H et al. Dermatol Basel Switz. 2019;235(6):478-487.
- Choi Harry et al. Circ Cardiovasc Imaging. 2020;13(9):e011199.
Disclaimer
This article is not medical advice. Patients should seek personal assessment by a licenced specialist. Physicians are recommended to read the full publication(s) as cited in the article before making medical decisions. This article does not supersede nor replace the published article(s).
© Copyright 2020 MediPaper Medical Communications Ltd. – Psoriasis biologics may help reduce coronary plaque
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© Copyright 2020 MediPaper Medical Communications Ltd. – Psoriasis biologics may help reduce coronary plaque
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