Some biologic drugs may reduce heart attack risk in people with psoriasis by almost 75 percent, according to the results of a recent study.
Researchers from Kaiser Permanente in California have found that treatment with a certain kind of biologic called tumor necrosis factor inhibitors can significantly reduce the risk of heart attacks in psoriatic disease patients, especially in people with psoriasis alone. Although a reduction was also seen in people with psoriatic arthritis, the improvement was too small to be considered significant, the researchers report.
The study appears in the current issue of the Journal of Drugs in Dermatology.
Tumor necrosis factor-alpha (TNF-alpha) is a cytokine, or protein, involved in inflammation. Several biologic medications block this cytokine, including Humira (adalimumab), Enbrel (etanercept) and Remicade (infliximab), the TNF inhibitors examined in this study.
The research team examined the health records of psoriatic disease patients enrolled in the Kaiser Permanente Southern California Health Plan. The study included 8,845 patients with psoriatic disease, 1,673 of whom were treated with TNF inhibitors.
In a previous study, the researchers found that treating psoriatic disease with TNF inhibitors was associated with a 50 percent reduction in heart attack risk, compared to treatment with topical therapy. The current study analyzed the effect of TNF inhibitors according to specific forms of psoriatic disease, looking separately at psoriasis, psoriatic arthritis, and people with both psoriasis and psoriatic arthritis.
According to the study results, TNF inhibitors were associated with a 74 percent reduction in heart attack risk, compared with the use of topical therapy, oral medications or phototherapy. People with psoriatic arthritis, or psoriasis and psoriatic arthritis combined, also had a reduced risk, but the effect was much smaller. Compared with other treatments, TNF inhibitors were associated with a 14 percent reduction in heart attack risk in people with psoriatic arthritis, and a 24 percent reduction for people with both forms of the disease.
Previous research has shown that the systemic inflammation resulting from psoriatic disease may also be a contributing factor to cardiovascular disease, a comorbidity of psoriatic disease. Reducing inflammation through TNF inhibitor therapy, therefore, may also reduce cardiovascular disease risk.
“TNF inhibitors can reduce systemic inflammation, which in turn may also help with the risk of heart attacks,” said Jashin Wu, a member of the NPF Medical Board and a co-author of the study.
The researchers note that because the level of inflammation in psoriatic arthritis can be higher than in psoriasis, TNF-alpha inhibitors may not be able to reduce inflammation enough to significantly reduce heart attack risk.