Psoriasis and risk of myocardial infarction before and during an era with biological therapy: a population‐based follow‐up study

Leisner, Michelle Z; Riis, Jette Lindorff; Gniadecki, Robert; Iversen, Lars; Olsen, Morten

doi:10.1111/jdv.15021

Cited by 14 publications

(12 citation statements)

References 34 publications

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“…United Health Group) did not show a reduced risk of MI in those receiving systemic therapy compared to those exposed to phototherapy 144 . A recent comparison of patients with first time hospital‐diagnosed psoriasis between 1995 and 2002 (early era cohort) and those diagnosed between 2006 and 2013 (late era cohort) did not show any change in MI risk despite increased cardiovascular disease prevention and the availability of biologic therapy 145 . A meta‐analysis of 22 randomized, placebo‐controlled, double‐blind studies of IL‐12/23 antibodies and anti‐TNF‐α agents comprising 10 183 adult patients evaluated the possible association between biologic therapies and major adverse cardiovascular events (MACE).…”

Section: Guidance For Specific Clinical and Comorbid Situationsmentioning

confidence: 95%

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Nast

Smith

Spuls

et al. 2021

Acad Dermatol Venereol

141

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This evidence‐ and consensus‐based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The second part of the guideline provides guidance for specific clinical and comorbid situations such as treating psoriasis vulgaris patient with concomitant psoriatic arthritis, concomitant inflammatory bowel disease, a history of malignancies or a history of depression or suicidal ideation. It further holds recommendations for concomitant diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or patients with a wish for a child in the near future. Information on vaccination, immunogenicity and systemic treatment during the COVID‐19 pandemic is also provided.

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Section: Guidance For Specific Clinical and Comorbid Situationsmentioning

confidence: 95%

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Nast

Smith

Spuls

et al. 2021

Acad Dermatol Venereol

141

View full text Add to dashboard Cite

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“…Immune-mediated disorders have been linked to increased cardiovascular events. Proposed mechanisms include autoantibodies, autoantigens, and inflammation triggering the synthesis and rupture of atherosclerotic plaque [8,[27][28].…”

Section: Inflammation Thrombosis and Coronary Diseasementioning

confidence: 99%

Pro-Atherogenic Inflammatory Mediators in Inflammatory Bowel Disease Patients Increase the Risk of Thrombosis, Coronary Artery Disease, and Myocardial Infarction: A Scientific Dilemma

Kondubhatla

Kaushal

Daoud

et al. 2020

Cureus

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Inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn's disease, is characterized by widespread inflammation of the gastrointestinal tract with systemic manifestations. Inflammation is one of the driving forces for the pathogenesis of atherosclerosis and its dreaded complications like myocardial infarction (MI). Yet, the association between IBD and myocardial infarction has not been thoroughly established. Myocardial infarction in IBD patients was predominantly seen in young women during the active disease process. At the same time, elevated levels of C-reactive protein and other proinflammatory markers were observed in both IBD and atherosclerosis. Increasing evidence suggests inflammation inhibits fibrinolysis, expresses procoagulants, and suppresses anticoagulants promoting thrombosis formation. Moreover, the alteration of gut microbiota impacts the pathogenesis of inflammation and predisposes one to ischemic heart disease. Accordingly, all IBD patients should be screened and counseled on lifestyle modifications for the traditional risk factors of atherosclerosis. Future researchers should consider conducting more clinical trials on anti-inflammatory medication targeting atherosclerosis and therapeutics, while targeting the gut microbiota to reverse the inflammatory atherosclerotic process.

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“…Moreover, traditional treatment might be ineffective [7][8][9]. For patients with moderate to severe psoriasis, biological therapy is prescribed when they do not tolerate the traditional systemic treatment because of its adverse effects or inefficacy [10]. Biologics are monoclonal antibodies targeting cytokines, such as interleukin (IL)-17, IL-23 and tumor necrosis factor alpha (TNF-α) [7].…”

Section: Introductionmentioning

confidence: 99%

A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology

et al. 2020

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Background and Objectives: Biological therapy is widely used for the treatment of severe psoriasis. The objective of this study was to evaluate the efficacy and safety of biological therapy for patients with severe psoriasis. Materials and Methods: A retrospective study of 79 patients with severe psoriasis, who have been treated with biological therapy between 2012 and 2018, was conducted. During this study, the following data were collected and evaluated: sex, age, body mass index (BMI), duration of illness, the results of treatment with biological therapy, concomitant therapy, Psoriasis Area and Severity Index (PASI) and adverse events. Results: In total, 74.7% (n = 59) of subjects were male. Their overall average age was 47.4 ± 11.4 (range: 18–73) years. Their baseline BMI was 27.6 ± 5.9, which increased to 29.6 ± 4.5 after 6 years of treatment. The mean duration of psoriasis was 25.7 ± 12.5 years. In total, 39.2% (n = 31) of subjects received infliximab, 36.7% (n = 29)—etanercept, 24.1% (n = 19)—ustekinumab. The treatment duration for infliximab, etanercept and ustekinumab was 201.6 ± 86.8, 156.2 ± 137.4 and 219.1 ± 95.7 weeks (p < 0.01), respectively. Overall, 65.8% (n = 52) of subjects were also on methotrexate; 30.8% (n = 16) of them discontinued it due to clinical improvement (31.3% (n = 5)), impaired liver function (31.3% (n = 5)), and intolerance (25% (n = 4)). Baseline PASI was 20.8 ± 8.8. PASI 50 was achieved by 96.2% (n = 76) of patients at week 11, PASI 75 by 86.1% (n = 68) at week 16, PASI 90 by 54.4% (n = 43) at week 35, and PASI 100 by 13.9% (n = 11) at week 33. The overall incidence rate of adverse events was 0.362 per patient year of follow-up. Conclusion: Biological therapy is an effective and safe treatment for patients with severe psoriasis.

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Psoriasis and risk of myocardial infarction before and during an era with biological therapy: a population‐based follow‐up study

Abstract: The increased risk of MI among patients with hospital-diagnosed psoriasis, relative to the general population, remained unchanged during the initial years of increased attention towards cardiovascular disease prevention and availability of biologic therapy.

Cited by 14 publications

References 34 publications

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Pro-Atherogenic Inflammatory Mediators in Inflammatory Bowel Disease Patients Increase the Risk of Thrombosis, Coronary Artery Disease, and Myocardial Infarction: A Scientific Dilemma

A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology

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