Effective continuous systemic therapy of severe plaque‐type psoriasis is accompanied by amelioration of biomarkers of cardiovascular risk: results of a prospective longitudinal observational study

Abstract

We document an amelioration of biomarkers of cardiovascular risk in patients with severe plaque-type psoriasis responding to continuous systemic therapy. The impact on the patients'metabolic state was found to be better if the psoriatic inflammation was controlled for longer. Future studies need to compare the cardioprotective effects of different treatment modalities, based on hard clinical endpoints.

Systemic treatment and narrowband ultraviolet B differentially affect cardiovascular risk markers in psoriasis

“…40 The cardiovascular risk biomarkers hs-CRP, VEGF and resistin decrease similarly in psoriasis both after biological therapy and methotrexate. 10 Our results are also supported by the data from Romaní et al, who observed increased systemic levels of LDL cholesterol, non-HDL (high-density lipoprotein) cholesterol and Apo-B in psoriasis patients, levels which were unaffected by phototherapy. 41 Signs of a persistent inflammatory process after UV therapy were also established by Coimbra et al 42 In contrast, UV therapy led to a decrease in IL-22, IL-17, IL-23, IL-8 TNF-α, and VEGF serum levels, 43 suggesting that the skin is the major source of these cytokines in psoriasis.…”

“…Systemic psoriasis treatment decreases the levels of the adipokine resistin and increases the levels of the anti-inflammatory cardioprotective adipokine adiponectin. 10 In a former study, we investigated circulating chemokines in psoriasis as a sign of an on-going systemic inflammation. Five chemokines of a Th1-, Th2-or Th17-associated phenotype were elevated in psoriasis plasma but not in healthy controls.…”

Early intervention in psoriasis and immune-mediated inflammatory diseases: A hypothesis paper

“…Outcome measures or endpoints could include disease severity over time; HRQoL over time; duration of disease-free remissions after treatment breaks; treatment response after change to conventional therapy; laboratory indicators of systemic inflammation; retreatment or change to conventional therapy; and biomarkers or surrogate indicators of systemic inflammation. Early pilot studies have suggested that the treatment of psoriasis with systemic agents or anti-TNFs may improve biomarkers of cardiovascular risks (126,127). Demonstration of a reduction in the incidence of cardiovascular or cerebrovascular events, metabolic syndrome, or PsA would represent a secondary gain, but the ultimate goal from a dermatological perspective, taking into account that no structural irreversible damage occurs in the skin, should be prolonged medication-free remission.…”

Cardiovascular disease biomarkers across autoimmune diseases

“…Recent studies are proving PsA to be a systemic disease akin to SLE and RA, rather than a disease confined to skin and joints [46]. Like SLE and RA, PsA patients have a heightened risk for CVD-associated mortality [46].…”