Calcium channel blocker exposure and psoriasis risk: Pharmacovigilance investigation and literature data

Azzouz, Brahim; Laugier-Castellan, Delphine; Sanchez-Peña, Paola; Rouault, Marie; Kanagaratnam, Lukshe; Morel, Aurore; Trenque, Thierry

doi:10.1016/j.therap.2020.05.013

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…8 CCBs can also disrupt the epidermal calcium gradient by inhibiting calcium channels in keratinocytes, ie, L-type voltage-gated calcium channels and canonical transient receptor channels. 29 Concomitant use of CCB and BB could therefore incur a higher risk of psoriasis, although our data do not support this hypothesis.…”

Section: Discussioncontrasting

confidence: 76%

Psoriasis risk after beta‐blocker exposure: Description of a pharmacovigilance signal

Azzouz

Guizelin

Lambert

et al. 2022

Brit J Clinical Pharma

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Aim We aimed to investigate French pharmacovigilance data. The objective was to characterize psoriatic conditions that occurred after beta‐blocker (BB) exposure and bring to light a possible pharmacovigilance signal. Methods Spontaneous reports of psoriatic conditions recorded in the French National Pharmacovigilance Database (FPVD) between 1985 and 2019 were extracted. We performed a retrospective, descriptive analysis of reports linked to BB exposure. Association between psoriasis risk and BB exposure was assessed using a case/noncase study. Results Two hundred and twenty‐five reports of psoriatic conditions after BB exposure were recorded in the FPVD during the study period. Both cardioselective and noncardioselective, topical and systemic BBs are involved. Therapeutic indication of BB was mainly hypertension. Mean time to onset was 5 months and outcome was favourable in 68% after BB discontinuation. These features were concordant with those of literature reports. The reporting odds ratio (ROR) was 8.95 (95% confidence interval 7.75‐10.33). Conclusion We highlighted a statistically significant disproportionality which constitutes a pharmacovigilance signal. Psoriasis risk with BBs is a class effect. Increasing surveillance during the first year of BB exposure is needed.

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Section: Discussioncontrasting

confidence: 76%

Psoriasis risk after beta‐blocker exposure: Description of a pharmacovigilance signal

Azzouz

Guizelin

Lambert

et al. 2022

Brit J Clinical Pharma

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“…[38][39][40] A hypothesis for the association between CCB use and psoriasis is related to intracellular calcium. [44][45][46] Dysregulations of epidermal barrier formation and hyperproliferation of keratinocytes are mainly responsible for the pathophysiology of psoriasis. [47][48][49] Calcium has been proposed to be the major factor in keratinocyte differentiation regulation.…”

Section: Discussionmentioning

confidence: 99%

“…A hypothesis for the association between CCB use and psoriasis is related to intracellular calcium 44–46 . Dysregulations of epidermal barrier formation and hyperproliferation of keratinocytes are mainly responsible for the pathophysiology of psoriasis 47–49 .…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive drug use and psoriasis: A systematic review, meta‐ and network meta‐analysis

Song

Yoon

Yee

et al. 2021

Brit J Clinical Pharma

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Aims Diverse genetic and/or external factors may induce psoriasis. Drug exposure is 1 such prominent external factor; antihypertensive drugs are reportedly associated with psoriasis, but study results have been inconsistent. In this context, we investigated the associations between antihypertensive drugs and incidence if psoriasis via a systematic literature review and meta‐analysis. Methods Literature search in databases such as PubMed, Embase and Web of Science was conducted on 8 January 2021, and obtained data were pooled for meta‐ and network meta‐analysis. Fixed‐ or random effect models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for evaluating the strength of the associations between antihypertensive drugs and psoriasis incidence. In addition to meta‐analysis, Bayesian network meta‐analysis was performed. ResultsThirteen eligible studies were included for meta‐analysis with 6 378 116 individuals and 8 studies for network meta‐analysis with 5 615 918 individuals. All antihypertensive drugs were significantly associated with psoriasis incidence. In a meta‐analysis, the pooled ORs were 1.67 (95% CI: 1.31–2.13) for angiotensin‐converting enzyme (ACE) inhibitors, 1.40 (95% CI: 1.20–1.63) for β‐blockers, 1.53 (95% CI: 1.23–1.89) for calcium‐channel blockers (CCBs), and 1.70 (95% CI: 1.40–2.06) for thiazide diuretics. For the comparative risks of psoriasis among antihypertensive drugs in the network meta‐analysis, ORs were 2.09 (95% CI: 1.39–3.18) for ACE inhibitors, 1.35 (95% CI: 0.99–1.91) for BBs, 1.53 (95% CI: 1.07–2.24) for CCBs and 1.80 (95% CI: 1.23–2.66) for thiazide diuretics. Conclusion This study confirmed the associations between antihypertensive drugs and psoriasis; ACE inhibitors, BBs, CCBs and thiazide diuretics increased the risk of psoriasis. Therefore, antihypertensive drug users should be carefully monitored for psoriasis.

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“…41 Thus, changes in skin vessels may affect systemic blood pressure. However, some antihypertensive drugs have been reported to increase the risk of psoriasis, [42][43][44] and therefore, further basic and clinical research regarding blood pressure control in patients with psoriasis is merited. These findings also suggest that the concepts of water loss as a trigger and subsequent water conservation may be important for an understanding of the pathogenesis of hypertension.…”

Section: Hif-1αmentioning

confidence: 99%

“…41 Thus, changes in skin vessels may affect systemic blood pressure. However, some antihypertensive drugs have been reported to increase the risk of psoriasis, 42–44 and therefore, further basic and clinical research regarding blood pressure control in patients with psoriasis is merited.…”

Section: Skin Barrier Dysfunction and Blood Pressurementioning

confidence: 99%

Potential Role of the Skin in Hypertension Risk Through Water Conservation

Kitada,

Nishiyama

2024

Hypertension

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Previous basic and clinical investigations have identified various pathogenic factors and determinants of risk that contribute to hypertension. Nevertheless, the pathogenesis of hypertension has not been fully elucidated. Moreover, despite the availability of antihypertensive medications for the management of blood pressure, treatments that address the full spectrum of the pathophysiological defects underpinning hypertension remain to be identified. To further investigate the mechanisms of primary hypertension, it is imperative to consider novel potential aspects, such as fluid management by the skin, in addition to the conventional risk factors. There is a close association between body fluid regulation and blood pressure, and the kidney, which, as the principal organ responsible for body fluid homeostasis, is the primary target for research in the field of hypertension. In addition, the skin functions as a biological barrier, potentially contributing to body fluid regulation. In this review, we propose the hypothesis that changes in skin water conservation are associated with hypertension risk based on recent findings. Further studies are required to clarify whether this novel hypothesis is limited to specific hypertension or applies to physiological blood pressure regulation.

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Calcium channel blocker exposure and psoriasis risk: Pharmacovigilance investigation and literature data

Cited by 7 publications

References 28 publications

Psoriasis risk after beta‐blocker exposure: Description of a pharmacovigilance signal

Psoriasis risk after beta‐blocker exposure: Description of a pharmacovigilance signal

Antihypertensive drug use and psoriasis: A systematic review, meta‐ and network meta‐analysis

Potential Role of the Skin in Hypertension Risk Through Water Conservation

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