Biologics may reduce the risk of heart disease
Encouraging new evidence suggests that biological treatment for psoriasis, may reduce the risk of coronary heart disease.
Biologics have been used in the treatment of psoriasis since the early 2000s. They block the actions of various inflammatory molecules – cytokines – which play a major role in the development of psoriasis and psoriatic arthritis.
Examples of pro-inflammatory cytokines include tumour necrosis factor alpha (TNF-alpha) and various interleukins, including IL-8, IL-12, IL-17 and IL-23. Examples of biologics which block the actions of these inflammatory molecules, include adalimumab and ustekinumab.
Heart and circulatory diseases are due to the build of fatty deposits in the walls of the arteries – known as plaque – which consist mainly of cholesterol deposits. In this study, researchers at the NHLBI in the US, used sophisticate imaging techniques to measure the amount of plaque in the coronary arteries of 209 patients with psoriasis who had not yet received treatment with biologics. Around half were given biological therapies, while the remainder were not. The amount of plaque in the coronary arteries was measured in both groups at baseline and then one-year later.
Results showed that those who received biologic therapy had a decline of about 5% in the amount plaque. Conversely, those who were not on biologic treatments, saw the amount of plaque actually increase - by about 7% (though this did not achieve statistical significance).
These are preliminary findings which need to be confirmed in larger studies, but they are considerable importance. Patients with psoriasis are known to be at greater risk of heart disease, so if a common and effective form of treatment for psoriasis, can simultaneously reduce the risk of heart problems, it represents a welcome additional benefit of treatment.
Choi H, Uceda DE, Dey AK et al. Treatment of Psoriasis With Biologic Therapy Is Associated With Improvement of Coronary Artery Plaque Lipid-Rich Necrotic Core. Circulation: Cardiovascular Imaging. 2020 | Volume 13, Issue 9.