Treatment for psoriasis and psoriatic arthritis seen to lower cardiovascular disease, says study

Tumour necrosis factor (TNF) inhibitors, commonly used to treat psoriasis and psoriatic arthritis patients, have been found to potentially lower the risk of heart attack or stroke.

The study, which was published in Clinical Reviews in Allergy and Immunology, says that previous research has indicated a high prevalence of cardiovascular risk factors in psoriatic patients. 

However, cardiovascular morbidity and mortality in patients with psoriasis and psoriatic arthritis is still under question, as it is difficult to assess what is attributable to the disease and what to confounding factors.

TNF inhibitors are used to treat this autoimmune disease, but their effects on cardiovascular events remains unclear. Researchers conducted an analysis of five clinical studies, identified through databases, that included nearly 50,000 psoriasis patients, with or without psoriatic arthritis.

Results showed that, compared to patients treated with topical agents or phototherapy, TNF inhibitor use was associated with a significantly lower risk of cardiovascular events, 42 percent lower. Likewise, people treated with TNF inhibitors had a 33 percent lower risk of such events compared to those treated with methotrexate.

The scientists point out that the study had some limitations, such as missing information on potential study confounders like comorbid diabetes and blood pressure. Despite this, they believe it stands out from previous research as, here, the scientists evaluated TNF inhibitors alone, as opposed to in conjugation with methotrexate, and in a large patient group with long-term follow-up.

However, they conclude, “TNF inhibitors appear to have net clinical benefits with regard to adverse cardiovascular events in [psoriasis] and/or [psoriatic arthritis]. Rigorous randomised controlled trials will need to evaluate whether TNF inhibitors truly result in reduction of cardiovascular diseases.”

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