Impact of Interleukin-17 Inhibitor Therapy on Arterial Intima-media Thickness among Severe Psoriatic Patients

Abstract

Background: Psoriasis is frequently accompanied by cardiovascular diseases based on the shared immunopathogenic pathway. Authors determined the effect of interleukin (IL)-17 inhibitor therapy on arterial intima-media thickness (IMT) among severe psoriatic patients. Methods: Thirty-one severe psoriatic patients were enrolled. Twenty received secukinumab and 11 received ixekizumab. Before treatment initiation and after 6 months, the carotid-brachial-femoral IMT, the Psoriasis Area Severity Index (PASI), the Dermatology Life Quality of Index (DLQI) and the EuroQol Visual Analogue Scale (EQ VAS) were evaluated. Results: After 6 months, significant ameliorations were observed in PASI (p < 0.001) from 18 to 0, in DLQI (p < 0.001) from 17 to 0, in EQ VAS (p < 0.001) from 60 to 90, in right carotid IMT (p < 0.001) from 1.1 mm to 0.8 mm, in left carotid IMT (p < 0.001) from 1.1 mm to 0.7 mm, in right brachial IMT (p < 0.001) from 0.75 mm to 0.6 mm, in left brachial IMT (p < 0.001) from 0.8 mm to 0.5 mm, in right femoral IMT (p < 0.001) from 0.9 mm to 0.7 mm and in left femoral IMT (p < 0.001) from 0.8 mm to 0.7 mm. Conclusions: By reducing the inflammation of the vascular wall, anti-IL-17 therapy may have a beneficial long-term effect on cardiovascular complications of systemic inflammation.

Effect of Secukinumab on Traditional Cardiovascular Risk Factors and Inflammatory Biomarkers: Post Hoc Analyses of Pooled Data Across Three Indications

“…Furthermore, in a randomized study in patients with psoriasis, impaired endothelial function at baseline, as measured by flow-mediated dilation, was modestly restored after 52 weeks of secukinumab treatment [ 44 ]. In another study, anti-IL-17 therapy showed ameliorations in arterial intima-media thickness after 6 months of treatment in patients with severe psoriasis, suggesting a potential beneficial effect of anti-IL-17 therapy on cardiovascular complications of systemic inflammation [ 45 ]. Secukinumab decreased hsCRP levels over 52 weeks in patients with psoriasis [ 46 ].…”

Does Systemic Anti-Psoriatic Treatment Impact the Risk of Cardiovascular Disease? A Review Over Cardiovascular Imaging Studies

“… Marovt et al [ 38 ] 2020 Ultrasonography and PWA PsO 15 None (change from baseline) Biologics [(anti-IL-12/23 and IL-17) secukinumab, ustekinumab and ixekizumab] PWV, augmentation index and IMT Biologics targeting the IL-23/IL-17 axis had no effect on vascular structure (IMT) and PWV after 6 months of treatment. Piros et al [ 39 ] 2021 Ultrasound PsO 31 None (change from baseline) Anti-IL-17 [secukinumab, ( N = 20), ixekizumab ( N = 11)] The carotid, brachial and femoral IMT Anti-IL-17 treatment was associated with reduced carotid, brachial and femoral atherosclerosis (IMT) after 6 months of treatment. Gelfand et al [ 40 ] 2022 FDG-PET/CT PsO 70 None (change from baseline) Apremilast Vascular inflammation (TBR) in entire aorta Apremilast had no effect on aortic vascular inflammation after 16 and 52 weeks of treatment.…”

Reducing cardiovascular risk in immune‐mediated inflammatory diseases: Tumour necrosis factor inhibitors compared to conventional therapies—A systematic review and meta‐analysis

“…RCTs with longer follow-up periods or further well-designed longitudinal studies using data from national and international registers are necessary. For the novel IL-23/Th-17 axis inhibitors, although some studies have shown beneficial effects on the surrogate markers of CV diseases, 107,108 recently published observational studies suggest that IL-12/23, IL-17 and IL-23 inhibitors might be associated with the risk of certain severe CV events. [109][110][111][112] Further comparative studies using real-world data on the effect of different biological therapies of IMIDs on CV risk are needed.…”