For patients with the skin condition, researchers found that psoriasis medication may have improved heart disease and coronary artery plaque.
Published today in Cardiovascular Research, a journal of the European Society of Cardiology (ESC), researchers have discovered that anti-inflammatory biologic drugs used to treat severe psoriasis have the potential to prevent and improve heart disease in patients with the skin condition.
Using psoriasis medication to improve heart disease
Dr Nehal Mehta, Chief of Inflammation and Cardiometabolic Diseases at the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), USA, explains: “Psoriasis severity is related to the burden of coronary disease – our findings suggest treating the psoriasis may potentially benefit coronary heart disease.”
Psoriasis causes scaly skin patches, often on the elbows, knees, scalp, and lower back.
Patients with the skin condition have an elevated risk of heart disease, particularly young patients with severe psoriasis are at twice the risk of having a first heart attack at 40-50 years of age.
Psoriasis patients often have inflammation throughout the body and may be treated with anti-inflammatory biologic therapy when their skin condition is severe and topical treatments or phototherapy have failed.
Details of the study
The study found that patients with severe psoriasis who took biologic therapy for one year had an 8% reduction in total and non-calcified coronary plaque burden, a frequent cause of heart attacks.
The make-up of coronary plaques also improved in those taking biologics, making them less risky. Coronary plaque burden increased by 2% in patients who did not take a biologic.
Mehta said: “We found that these anti-inflammatory drugs commonly used to treat severe psoriasis also improve plaque in the coronary artery making them more stable and less likely to cause a heart attack. This occurred in the absence of changes in traditional cardiovascular risk factors including blood pressure and blood lipids.”
He adds: “This preliminary study provides the first evidence that biologic therapy is associated with coronary plaque reduction and stabilisation and provides strong rationale for conduct of a randomised trial testing the impact of biologic therapy on the progression of coronary disease in patients with psoriasis.”
Previous research has shown that in heart attack patients, anti-inflammatory biologic therapy reduces the risk of another cardiovascular event.
“Take untreated inflammation seriously”
“With the results of that study and our current one, my message to patients with psoriasis is to take untreated inflammation seriously,” said Dr Mehta. “When someone has severe psoriasis, they are at higher risk of heart attack and treating the psoriasis may reduce that risk.”
The observational study included 121 patients with severe psoriasis who qualified for biologic treatment. Of those, 89 took biological therapy (one of three types) and 32 used topical treatment. All patients underwent imaging of their coronary arteries with computed tomography angiography at baseline and one year later to assess the amount and characteristics of plaques such as the necrotic core which causes plaque rupture.
