Studying the effect of systemic and biological drugs on intima‐media thickness in patients suffering from moderate and severe psoriasis

Martínez-López, Antonio; Blasco‐Morente, Gonzalo; Pérez-López, Israel; Tercedor-Sánchez, J.; Arias‐Santiago, Salvador

doi:10.1111/jdv.14841

Cited by 40 publications

(59 citation statements)

References 52 publications

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“…70 Furthermore, a study of 53 patients with moderateto-severe psoriasis reported that methotrexate and ustekinumab significantly decreased carotid intima-media thickness levels. 71 Other studies have shown improvement in measures of cardiovascular function with systemic psoriasis therapies. [72][73][74][75] The effect of secukinumab on endothelial dysfunction in moderateto-severe psoriasis without severe CVD is currently being evaluated in the prospective CARIMA study (NCT02559622).…”

Section: Goal 2: Reverse Existing Damage/comorbid Conditions Caused Bmentioning

confidence: 98%

“…Additionally, a study of 105 patients with varying degrees of psoriasis severity used CT angiography to show that treatment with systemic or biological agents was associated with improvement in noncalcified coronary plaque burden . Furthermore, a study of 53 patients with moderate‐to‐severe psoriasis reported that methotrexate and ustekinumab significantly decreased carotid intima‐media thickness levels . Other studies have shown improvement in measures of cardiovascular function with systemic psoriasis therapies .…”

Section: Goals For Treating Systemic Inflammation In Psoriasismentioning

confidence: 99%

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Management of psoriasis as a systemic disease: what is the evidence?

2019

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Summary Background Psoriasis is a chronic, systemic immune‐mediated disease characterized by development of erythematous, indurated, scaly, pruritic and often painful skin plaques. Psoriasis pathogenesis is driven by proinflammatory cytokines and psoriasis is associated with increased risk for comorbidities, including, but not limited to, psoriatic arthritis, cardiovascular disease, diabetes mellitus, obesity, inflammatory bowel disease and nonalcoholic fatty liver disease compared with the general population. Objectives To explore the pathophysiological relationship between psoriasis and its common comorbidities and discuss the need for new treatment paradigms that include strategies to reduce systemic inflammation in patients with moderate‐to‐severe psoriasis. Methods This narrative review summarizes the published evidence related to the ability of biological therapies to ameliorate the consequences of systemic inflammation in patients with psoriasis. Results Current evidence suggests that preventing damage associated with inflammation, and preventing development of future inflammatory damage and comorbidities, may be a potentially achievable treatment goal for many patients with moderate‐to‐severe plaque psoriasis when biological therapies are utilized early in the disease. Encouraging data from recent studies suggest that the loftier goal of reversing existing inflammatory damage and improving signs and symptoms of inflammatory comorbidities could also possibly be attainable. Conclusions Results from ongoing prospective studies regarding the effects of biologics on markers of systemic inflammation in patients with psoriasis will strengthen the clinical evidence base that can be used to inform treatment decisions for patients with moderate‐to‐severe psoriasis. What's already known about this topic? Psoriasis is a systemic inflammatory disease and treatments are needed to optimize patient outcomes. What does this study add? This review discusses new psoriasis treatment paradigms that may potentially reduce effects of systemic inflammation. Evidence demonstrating that biological treatment may prevent or reverse inflammatory damage associated with psoriasis comorbidities is reviewed.

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Section: Goal 2: Reverse Existing Damage/comorbid Conditions Caused Bmentioning

confidence: 98%

Section: Goals For Treating Systemic Inflammation In Psoriasismentioning

confidence: 99%

Management of psoriasis as a systemic disease: what is the evidence?

2019

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“…Similarly, elevation of liver enzymes was seen in rheumatoid arthritis patients treated with infliximab, adalimumab and etanercept . A study of systemic and biologic anti‐inflammatory drugs in psoriasis patients showed limited impact on lipid profiles, with an overall rise in low‐density lipoprotein (LDL) cholesterol …”

Section: Introductionmentioning

confidence: 99%

“…21 A study of systemic and biologic anti-inflammatory drugs in psoriasis patients showed limited impact on lipid profiles, with an overall rise in low-density lipoprotein (LDL) cholesterol. 22 Secukinumab is a fully human monoclonal antibody that selectively neutralizes IL-17A, a key cytokine involved in the development of psoriasis. 23 Secukinumab has shown efficacy and safety in the complete spectrum of psoriasis manifestations, including PsA.…”

Section: Introductionmentioning

confidence: 99%

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

Gerdes

Pinter

Papavassilis

et al. 2019

Acad Dermatol Venereol

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Background Psoriasis is associated with metabolic, liver and cardiovascular comorbidity. Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin‐17A, has shown significant and sustained efficacy in the treatment of moderate to severe psoriasis. Objectives This was an exploratory post hoc analysis of pooled data from three phase 3 studies in plaque psoriasis patient populations. The objective was to show the course of metabolic and liver parameters under secukinumab, etanercept or placebo treatment over time. A further objective was to assess the impact of selected comorbidities and metabolic characteristics on high‐sensitivity C‐reactive protein (hs‐CRP), as a surrogate marker of systemic inflammation. Methods Data from the phase 3 randomized controlled trials [FIXTURE (NCT01358578), ERASURE (NCT01365455) and SCULPTURE (NCT01406938); n = 3010] were included in this analysis. Patients were treated with secukinumab 150 mg or 300 mg, placebo or etanercept 50 mg (FIXTURE only) as active comparator. A set of metabolic and liver parameters was longitudinally assessed over 52 weeks. Multivariate regression analyses assessed the impact of selected comorbidities and metabolic characteristics on hs‐CRP levels at baseline and under treatment. Results Secukinumab treatment reduced hs‐CRP levels. Body weight and uric acid levels tended to decrease over 52 weeks with secukinumab. Secukinumab showed a neutral effect on fasting plasma glucose, lipid parameters and liver enzymes. Psoriatic arthritis, metabolic syndrome, obesity, impaired glucose metabolism, and hyperuricemia were each associated with increased hs‐CRP levels at baseline. Concomitant obesity attenuated the decline in hs‐CRP under treatment. Conclusions These analyses suggest neutral to favourable long‐term trends in metabolic and liver parameters under secukinumab treatment. Metabolic comorbidities were associated with increased hs‐CRP levels, reflecting the role of systemic inflammatory processes in their pathophysiology.

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“…No change in CIMT post-anti-TNFα therapy. 45 13 psoriasis 53 psoriasis patients recruited, of whom 13 were treated with anti-TNFα agents. Compared with 30 DMARD patients and 10 on other biological drugs.…”

Section: No Change In Aixmentioning

confidence: 99%

Do anti‐tumour necrosis factor‐α biologics affect subclinical measures of atherosclerosis and arteriosclerosis? A systematic review

Knowles

Nadeem

Chowienczyk

2020

Brit J Clinical Pharma

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Aims: Inflammatory cytokines, particularly tumour necrosis factor-α (TNFα), are thought to promote arterial disease through a variety of mechanisms leading to arteriosclerosis and atherosclerosis. We reviewed the existing evidence of the effect of anti-TNFα treatment on arteriosclerosis and atherosclerosis in chronic inflammatory disease. Methods:We performed a systematic review of studies examining effects of monoclonal antibodies against TNFα on subclinical measures of arteriosclerosis (arterial pulse wave velocity) and atherosclerosis (endothelial function measured by flowmediated dilation or forearm blood flow responses to endothelium-dependent agonists, and common carotid intima-media thickness). Results:We identified 60 studies (of 854 potential studies identified using a systematic search) in which effects of anti-TNFα biologics on these measures were assessed in patients receiving anti-TNFα therapy for a clinical indication (usually an inflammatory disease such as an inflammatory arthritis, psoriasis or inflammatory bowel disease). Of these, only 6 were randomised clinical controlled trials. Whilst many observational studies and noncontrolled studies reported positive findings, positive finding were reported in only 1 of 6 randomised clinical controlled trials. Conclusions:There is no strong evidence for an effect of anti-TNFα biologics on the subclinical measures of arteriosclerosis or atherosclerosis examined in this review.This does not exclude a positive effect of TNFα biologics on clinical outcomes through alternate pathways including those induced by remission of the primary inflammatory disease.

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Studying the effect of systemic and biological drugs on intima‐media thickness in patients suffering from moderate and severe psoriasis

Abstract: Our study suggests that the carotid IMT may benefit from treatment with biological drugs, particularly anti-IL-12/23 and methotrexate in patients suffering from moderate and severe psoriasis. However, larger longitudinal studies should be performed to fully confirm these results.

Cited by 40 publications

References 52 publications

Management of psoriasis as a systemic disease: what is the evidence?

Management of psoriasis as a systemic disease: what is the evidence?

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

Do anti‐tumour necrosis factor‐α biologics affect subclinical measures of atherosclerosis and arteriosclerosis? A systematic review

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