Psoriasis as initiator or amplifier of the systemic inflammatory march: impact on development of severe vascular events and implications for treatment strategy

Su, Yu-Feng; Yu, Hsin‐Su; Li, W.-C.; Ko, Ying‐Chin; Chen, G.-S.; Wu, Ching‐Shuang; Lu, Yiwei; Yang, Yi‐Hsin; Lan, C.‐C. E.

doi:10.1111/j.1468-3083.2012.04599.x

Cited by 17 publications

(11 citation statements)

References 24 publications

(65 reference statements)

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“…Sex was mainly linked to frequencies of hypertension and smoking, and the severity of psoriasis to obesity. A recent Taiwanese case–control study evaluated whether the sequence of events psoriasis and metabolic disorder onsets could affect the risk for subsequent development of cardiovascular complications . Psoriasis was considered the initiator of the inflammatory march when comorbidities developed after its onset, and was a potent amplifier of pre‐existing comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Childhood-onset psoriasis: association with future cardiovascular and metabolic comorbidities

et al. 2013

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SummaryBackground Psoriasis is associated with higher prevalences of cardiovascular and metabolic comorbidities in adults but the relationship of age at onset and those prevalences is unknown. Objective To evaluate whether the childhood onset of psoriasis (COP) is correlated with the frequency of cardiovascular and metabolic comorbidities in adulthood. Methods This noninterventional, cross-sectional, multicentre study of adults with psoriasis was conducted in 29 dermatology centres in France. Data on sex, age at onset of psoriasis and its clinical characteristics, and cardiovascular risk factors, including weight, body mass index, waist circumference, dyslipidaemia, diabetes, hypertension, smoking, and personal/familial major adverse cardiovascular events (MACE) were systematically recorded. Results Two thousand two hundred and one patients with psoriasis (male: 56%; mean age: 49 years; 25% with COP) were included consecutively in the study. Univariate analysis showed that COP was associated with lower frequencies of obesity, high waist circumference, diabetes, dyslipidaemia, hypertension, familial cardiovascular disease, MACE and metabolic syndrome, but more frequent active smoking. Multivariate analysis retained age as being associated with frequency of cardiovascular and metabolic comorbidities, and sex with smoking, but not age at the onset of psoriasis. Psoriasis severity was associated with higher frequencies of obesity and psoriatic arthritis. Conclusion Our results showed that COP does not seem to be an additional risk factor for higher frequencies of cardiovascular and metabolic comorbidities during adulthood.

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Section: Discussionmentioning

confidence: 99%

Childhood-onset psoriasis: association with future cardiovascular and metabolic comorbidities

et al. 2013

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“…It was found that the risk of developing severe vascular events is higher when psoriasis acts as the disease amplifier compared to when it acts as the disease initiator. In addition, when psoriasis acts as the disease amplifier, methotrexate therapy was associated with a lower risk of developing cerebrovascular disease [ 50 ].…”

Section: Psoriasis and Severe Vascular Eventsmentioning

confidence: 99%

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Lan

2017

IJMS

147

121

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Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment.

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“…Epidemiology studies from different parts of the world have repeatedly shown that psoriasis is associated with higher occurrences of different components of metabolic syndrome and severe vascular complications [1]. Therefore, psoriasis is currently considered as a systemic inflammatory disorder and that the concept of ''psoriatic march'', with psoriasis serving as the initiator or the amplifier of the systemic inflammatory march, has been proposed to explain the increased occurrences of severe vascular events observed among psoriatic patients [3,4]. In terms of life expectancy, psoriatic patients were shown to have a higher mortality rates as compared to general population, particularly due to cardiovascular diseases and malignancies [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Psoriatic patients with diabetes are prone to develop digestive organ cancers: A population-based study in Taiwan

Lan¹,

Ko²,

Yu³

et al. 2012

Journal of Dermatological Science

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Psoriasis as initiator or amplifier of the systemic inflammatory march: impact on development of severe vascular events and implications for treatment strategy

Cited by 17 publications

References 24 publications

Childhood-onset psoriasis: association with future cardiovascular and metabolic comorbidities

Childhood-onset psoriasis: association with future cardiovascular and metabolic comorbidities

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Psoriatic patients with diabetes are prone to develop digestive organ cancers: A population-based study in Taiwan

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