Treatment of Psoriasis with biologic drugs improved coronary artery disease plaque in one year
Anti-inflammatory biologic drugs used to treat severe psoriasis have the potential to prevent coronary artery (heart) disease in patients with the skin condition. The findings of a research that came to this conclusion have been published the journal of the European Society of Cardiology (ESC).
During one year of treatment, biologic therapy improved coronary artery plaque similar to the effect of a low-dose statin.
“Psoriasis severity is related to the burden of coronary disease – our findings suggest treating the psoriasis may potentially benefit coronary heart disease,” said study author Dr Nehal Mehta, Chief of Inflammation and Cardiometabolic Diseases at the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland, US.
The make-up of coronary plaques also improved in those taking biologics, making them less prone to rupture. Coronary plaque burden increased by 2% in patients who did not take a biologic
Psoriasis causes scaly skin patches, often on the elbows, knees, scalp, and lower back. Patients with the skin condition have an elevated risk of heart disease – young patients with severe psoriasis are at twice the risk of having a first heart attack at 40-50 years of age.
Psoriasis patients often have inflammation throughout the body and may be treated with anti-inflammatory biologic therapy when their skin condition is severe and topical treatments or phototherapy have failed. This study investigated whether treating severe psoriasis with a biologic could improve the health of the coronary arteries.
The observational study included 121 patients with severe psoriasis who qualified for biologic treatment. Of those, 89 took biological therapy (one of three types) and 32 used topical treatment. All patients underwent imaging of their coronary arteries with computed tomography angiography at baseline and one year later to assess the amount and characteristics of plaques such as the necrotic core which causes plaque rupture.
The study found that patients with severe psoriasis who took biologic therapy for one year had an 8% reduction in total and non-calcified coronary plaque burden, a frequent cause of heart attacks – similar to the effect of a low dose statin. This occurred in the absence of changes in traditional cardiovascular risk factors including blood pressure and blood lipids.
The make-up of coronary plaques also improved in those taking biologics, making them less prone to rupture. Coronary plaque burden increased by 2% in patients who did not take a biologic.
During the one-year study, systemic inflammation assessed by blood markers reduced only in the group taking biologic therapy. Dr Mehta said it is too early to say whether biologics exert their effects on coronary plaques directly or by reducing systemic inflammation.
“When someone has severe psoriasis, they are at higher risk of heart attack and treating the psoriasis may reduce that risk,” added Dr Mehta.
