A Care Coordination Model to Prevent Cardiovascular Events in Patients with Psoriatic Disease: A Multicenter Pilot Study

Song, William B.; Garshick, Michael S.; Barbieri, John S.; Shin, Daniel B.; Báez, Suzette; Papadopoulos, Maryte; Neopaney, Aakriti; Fitzsimmons, Robert; Kalb, Robert E.; Mease, Philip J.; Craig, Ethan T.; Koplin, Joelle; Takeshita, Junko; Chiesa Fuxench, Zelma C.; Armstrong, April W.; Mehta, Nehal N.; Beidas, Rinad S.; Ogdie, Alexis R.; Gelfand, Joel M.

doi:10.1016/j.jid.2023.12.008

Cited by 6 publications

(1 citation statement)

References 7 publications

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“…134 Song et al proposed a clinical care model where dermatologists or rheumatologists screen patients for CVD risks and refer them to a care coordinator at the NPF. 135 The coordinator assesses the patient's 10-year risk of developing atherosclerotic CVD and formulates a comprehensive plan covering diet, exercise, and smoking cessation, in collaboration with the patient's primary care provider, including statin therapy if warranted. However, despite recommendations, statin initiation remains low, with only two out of 23 patients starting treatment, though these patients showed significant improvements in their CV risk parameters.…”

Section: Care-coordination Modelsmentioning

confidence: 99%

Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review

Mehta,

Narang,

Dogra

et al. 2024

VHRM

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Psoriasis, a prevalent chronic inflammatory skin disorder affecting 2–3% of the global population, has transcended its dermatological confines, revealing a profound association with cardiovascular diseases (CVD). This comprehensive review explores the intricate interplay between psoriasis and cardiovascular system, delving into genetic links, immune pathways, and adipose tissue dysfunction beyond conventional CVD risk factors. The pathophysiological connections unveil unique signatures, distinct from other inflammatory skin conditions, in particular psoriasis-specific genetic polymorphisms in IL-23 and TNF-α have consistently been linked to CVD. The review navigates the complex landscape of psoriasis treatments, addressing challenges and future directions in particular relevance to CVDs in psoriasis. Therapeutic interventions, including TNF inhibitors (TNFi), present promise in reducing cardiovascular risks, and methotrexate could constitute a favourable choice. Conversely, the relationship between IL-12/23 inhibitors and cardiovascular risk remains uncertain, while recent evidence indicates that Janus kinase inhibitors may not carry CVD risks. Emerging evidence supports the safety and efficacy of IL-17 and IL-23 inhibitors in patients with CVDs, hinting at evolving therapeutic paradigms. Lifestyle modifications, statins, and emerging therapies offer preventive strategies. Dedicated screening guidelines for CVD risk assessment in psoriasis are however lacking. Further, the impact of different disease phenotypes and treatment hierarchies in cardiovascular outcomes remains elusive, demanding ongoing research at the intersection of dermatology, rheumatology, and cardiology. In conclusion, unraveling the intricate connections between psoriasis and CVD provides a foundation for a holistic approach to patient care. Collaboration between specialties, advancements in screening methodologies, and a nuanced understanding of treatment impacts are essential for comprehensive cardiovascular risk management in individuals with psoriasis.

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Section: Care-coordination Modelsmentioning

confidence: 99%

Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review

Mehta,

Narang,

Dogra

et al. 2024

VHRM

View full text Add to dashboard Cite

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Psoriasis and Atherosclerotic CV Disease—Risk Factor or Risk Marker?

Garshick,

Weber,

Gelfand

2024

JAMA Cardiol

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Psoriasis, an immune-mediated inflammatory disease, primarily involves the skin and joints and is common, impacting almost 8 million adults in the US. 1 Psoriasis can occur at any age, but incidence initially spikes in young adulthood and gradually increases in the following decades. 1 Psoriasis has emerged as one of the beststudied immune-mediated inflammatory diseases with respect to major cardiovascular (CV) events. A meta-analysis of 75 studies encompassing 500 000 patients with psoriasis observed CV disease as approximately 50% higher when compared to those without psoriasis. 1 Psoriasis is also associated with numerous cardiometabolic comorbidities. 1 However, large-scale epidemiological studies and carefully controlled CV imaging studies suggest psoriasis is associated with CV disease independent of traditional CV risk factors and in a doseresponse manner. 1 Within this context, Ramessur et al 2 conducted a 2-sample mendelian randomization study using variants from a large psoriasis genome-wide association study meta-analysis to investigate the relationship between genetic predictors of psoriasis and atherosclerotic cardiovascular disease (ASCVD). They found that while genetic predictors of psoriasis were not associated with enhanced ASCVD risk, genetic predictors of ASCVD, including coronary artery disease (CAD; odds ratio [OR], 1.07; 95% CI, 1.04-1.10) and stroke (OR, 1.22; 95% CI, 1.05-1.41), were associated with psoriasis. Genetic predictors of ASCVD were specifically associated with psoriasis and not other immune-mediated diseases examined, including asthma, multiple sclerosis, rheumatoid arthritis, atopic dermatitis, and inflammatory bowel disease.Their results are consistent with another mendelian randomization investigation describing shared systemic inflammatory pathways and a causal relationship of genetic predictors of CAD driving psoriasis but not of genetic predictors of psoriasis promoting CAD. 3 However, despite a strong statistical association of genetic susceptibility loci with psoriasis, the overall predictive value of these loci may be low given the modest association of these loci with psoriasis and the relatively low prevalence of psoriasis in the general population. 4 In other words, only a small proportion of the patients with the genetic instrument studied actually have psoriasis, and even fewer will have moderate to severe psoriatic disease, in which the most clinically significant associations between psoriasis and ASCVD are observed.Regardless, there is now a series of mendelian randomization studies on psoriasis, which provide new insights into this complex relationship. For example, in contrast to Ramessur et al, 2 other mendelian randomization studies have ob-

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Screening for cardiometabolic risk factors in patients with psoriasis and hidradenitis suppurativa: A pilot study in a safety net population

Sanchez-Anguiano,

Klufas,

Amerson

2024

Journal of the American Academy of Dermatology

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A Care Coordination Model to Prevent Cardiovascular Events in Patients with Psoriatic Disease: A Multicenter Pilot Study

Cited by 6 publications

References 7 publications

Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review

Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review

Psoriasis and Atherosclerotic CV Disease—Risk Factor or Risk Marker?

Screening for cardiometabolic risk factors in patients with psoriasis and hidradenitis suppurativa: A pilot study in a safety net population

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