Psoriasis and Major Adverse Cardiovascular Events: A Systematic Review and Meta‐Analysis of Observational Studies

Armstrong, Ehrin J.; Harskamp, Caitlin T.; Armstrong, April W.

doi:10.1161/jaha.113.000062

Cited by 359 publications

(322 citation statements)

References 46 publications

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“…According to a meta-analysis of nine observational studies, patients with severe psoriasis have an increased risk of MACEs; in particular, these patients had a 39% increased risk of cardiovascular death, a 70% increased risk of a myocardial infarction (MI), and a 56% increased risk of stroke compared with the general US population [27]. In an analysis of over 12,000 patients in the Psoriasis Longitudinal Assessment and Registry Study (PSOLAR), the cumulative overall rate of MACEs in patients with psoriasis was 0.36 per 100 patient-years [28].…”

Section: Adjudicated Macesmentioning

confidence: 99%

Safety of secukinumab in the treatment of psoriasis

Blauvelt

2016

Expert Opinion on Drug Safety

104

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Introduction: Secukinumab is a human monoclonal antibody that selectively targets and neutralizes interleukin (IL)-17A, a cytokine that is normally involved in mucocutaneous defense against extracellular organisms and is abnormally expressed in psoriasis. In 2015, secukinumab was the first IL-17A inhibitor approved for the treatment of moderate-to-severe psoriasis. Areas covered: This review evaluates the safety profile of secukinumab for the treatment of moderateto-severe psoriasis and its role in the clinical landscape. A literature search was performed for articles published through February 2016; additional data from a pooled safety analysis of 10 Phase II and III secukinumab studies were reviewed. Expert opinion: Collectively, these studies show that secukinumab demonstrates a highly favorable safety profile, especially compared with commonly used psoriasis treatments such as methotrexate and TNF-α blockers. More specifically, secukinumab carries no increased risks for end-organ toxicities, serious infection, multiple sclerosis, reactivation of latent tuberculosis or hepatitis B, leukemia/lymphoma, and nonmelanoma skin cancer. Mucocutaneous candidiasis is a common side effect and occurs at a rate of 3.55/100 subject-years with secukinumab 300 mg, yet these infections usually do not interfere with maintenance of secukinumab therapy. The combination of proven efficacy and safety make secukinumab an excellent new treatment choice for individuals with moderate-to-severe psoriasis.ARTICLE HISTORY

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Section: Adjudicated Macesmentioning

confidence: 99%

Safety of secukinumab in the treatment of psoriasis

Blauvelt

2016

Expert Opinion on Drug Safety

104

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“…An elevated risk of cardiovascular disease is also known to occur in psoriasis,50 and is responsible for 20–56% of deaths in patients with PsA 51. Alongside high disease activity, the presence of co‐morbidity has been found to impact health‐related QoL (HRQoL) in patients with PsA 49.…”

Section: Mitigating the Impact Of Psa On The Patientmentioning

confidence: 99%

Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Betteridge

Boehncke

Bundy

et al. 2015

Acad Dermatol Venereol

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Patients with psoriatic arthritis (PsA) may not be optimally treated. The impact of the disease extends beyond skin and joint symptoms, impairing quality of life. This indicates that the adoption of a patient‐focused approach to PsA management is necessary. An expert multidisciplinary working group was convened, with the objective of developing an informed perspective on current best practice and needs for the future management of PsA. Topics of discussion included the barriers to current best practice and calls to action for the improvement of three areas in PsA management: early and accurate diagnosis of PsA, management of disease progression and management of the impact of the condition on the patient. The working group agreed that, to make best use of the available of diagnostic tools, clinical care recommendations and effective treatments, there is a clear need for healthcare professionals from different disciplines to collaborate in the management of PsA. By facilitating appropriate and rapid referral, providing high quality information about PsA and its treatment to patients, and actively involving patients when choosing management plans and setting treatment goals, management of PsA can be improved. The perspective of the working group is presented here, with recommendations for the adoption of a multidisciplinary, patient‐focused approach to the management of PsA.

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“…Patients with rheumatoid arthritis (RA) and other chronic inflammatory disorders (eg, psoriasis and inflammatory bowel disease) suffer considerably increased cardiovascular morbidity and mortality when compared with the background population 1, 2, 3, 4, 5. In patients with RA, the excess cardiovascular disease risk appears to be comparable with that found in patients with type 2 diabetes mellitus 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Incident Heart Failure in Patients With Rheumatoid Arthritis: A Nationwide Cohort Study

Khalid

Egeberg

Ahlehoff

et al. 2018

JAHA

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BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease associated with a wide range of comorbidities, including cardiovascular disease, but its association with heart failure (HF) is not fully clear. We investigated the risk of incident HF in a nationwide cohort of patients with RA.Methods and ResultsThe study comprised the entire Danish population aged ≥18 years followed from January 1, 2008 until first hospitalization for HF, emigration, December 31, 2012, or death. Information on comorbidity, medication, and socioeconomic status was identified by individual‐level linkage of administrative registers. Patients with a rheumatologist diagnosis of RA between 1978 and 2008 were included. The primary study outcome was incident HF defined as first hospital admission for HF. Incidence rates of HF per 1000 person‐years were calculated and incidence rate ratios adjusted for age, sex, calendar year, comorbidity, medications, socioeconomic status, smoking, and alcohol consumption were estimated. A total of 4 305 225 subjects with no history of HF were eligible for analysis at the study start. Of these subjects, 24 343 developed RA and 50 623 were hospitalized for HF. Overall incidence rates of incident HF were 2.43 and 6.64 for the reference population (n=49 879) and patients with RA (n=744), respectively. Correspondingly, the fully adjusted incidence rate ratio for incident HF was increased in patients with RA with incidence rate ratio 1.30 (95% confidence interval, 1.17–1.45).ConclusionsIn this cohort study, RA was associated with an increased hospitalization for HF. These findings add significantly to the existing evidence of RA as a clinically relevant risk factor for HF.

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Psoriasis and Major Adverse Cardiovascular Events: A Systematic Review and Meta‐Analysis of Observational Studies

Cited by 359 publications

References 46 publications

Safety of secukinumab in the treatment of psoriasis

Safety of secukinumab in the treatment of psoriasis

Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Incident Heart Failure in Patients With Rheumatoid Arthritis: A Nationwide Cohort Study

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