Impact of adalimumab treatment on cardiovascular risk biomarkers in psoriasis: Results of a pilot study

Abstract

Psoriasis is a chronic systemic immune-mediated inflammatory dermatosis associated with several comorbidities. Psoriasis patients are at increased risk of developing cardiovascular diseases (CVD), namely, coronary heart disease, stroke or peripheral vascular disease, and psoriasis seems to be an independent cardiovascular risk factor. Antipsoriatic systemic therapy, especially anti-tumor necrosis factor (TNF)-a, seems to exert a beneficial effect on these comorbidities. The purpose of this study was: (i) to measure the level of cardiovascular serum markers in psoriasis patients in comparison with healthy volunteers; and (ii) to compare the serum level of the same markers in patients before and 3 months after adalimumab therapy. We investigated six biomarkers connected to CVD: Creactive protein (measured high sensitively, hsCRP), oxidized low-density lipoproteins (oxLDL), oxLDL/b-glycoprotein I complex (oxLDL/b2GPI), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin and interleukin (IL)-22. These biomarkers were measured in 21 patients with moderate/severe psoriasis before and after treatment with adalimumab and in healthy volunteers. hsCRP (P < 0.05), oxLDL-b2GPI complex (P < 0.05), E-selectin (P < 0.001) and IL-22 (P < 0.001) were significantly increased in comparison with healthy controls, whereas oxLDL and VCAM-1 were also higher in psoriasis patients but the difference did not reach statistical significance. A decrease of E-selectin (P < 0.001) and IL-22 (P < 0.001) was observed after 3 months of adalimumab therapy. Inhibition of TNF-a seems to not only improve psoriasis but also decreases serum cardiovascular biomarkers. E-selectin and IL-22 could serve for monitoring of the efficacy of antipsoriatic systemic therapy on cardiovascular risk.

Effects of secukinumab on metabolic and liver parameters in plaque psoriasis patients

“…There are limited data available on the impact of systemic psoriasis treatments on metabolic and cardiovascular parameters. A study of adalimumab in 21 patients demonstrated a decrease at 12 weeks in E‐selectin and IL‐22, but no impact on vascular inflammation was seen with adalimumab in an FDG‐PET imaging study . Ixekizumab, which also targets IL‐17A, showed a neutral impact on metabolic parameters .…”

Risk of cardiovascular diseases in psoriasis – the current state of knowledge

“…TNF-α inhibitors or methotrexate, decrease the risk of death due to cardiovascular incidents. Gkalpakiotis et al [49] showed a decrease in E-selectin and IL-22 concentration in serum after 3 month of therapy with adalimumab in patients with moderate to severe psoriasis. Similarly Wu et al confirmed a statistically significant reduction of CRP concentration in patients suffering from psoriasis, psoriatic arthritis, and rheumatoid arthritis after the treatment with methotrexate and TNF-α inhibitors [50].…”

“…Gkalpakiotis i wsp. [49] wykazali zmniejszenie stężenia w surowicy E-selektyny i IL-22 po 3 miesiącach terapii adalimumabem u pacjentów z łuszczycą umiarkowaną do ciężkiej. Podobnie Wu i wsp.…”

Autoimmunity and autoimmune co‐morbidities in psoriasis

“…The high cost of biologicals limits access to these medications; however, cost‐saving biosimilars are rapidly advancing to the market worldwide . Biologicals are effective not only for psoriasis but also for co‐morbid cardiovascular and metabolic diseases . In addition, monitoring of infection is mandatory to avoid serious consequences .…”

“…[89][90][91] Biologicals are effective not only for psoriasis but also for co-morbid cardiovascular and metabolic diseases. 92,93 In addition, monitoring of infection is mandatory to avoid serious consequences. [94][95][96] The emergence of antidrug antibodies is another important issue that reduces the treatment response and promotes treatment failure during biological therapy.…”