Cardiometabolic Comorbidities in Patients With Psoriasis: Focusing on Risk, Biological Therapy, and Pathogenesis

Cai, Jiangluyi; Cui, Lian; Wang, Yu; Li, Ying; Zhang, Xilin; Shi, Yujun

doi:10.3389/fphar.2021.774808

Cited by 25 publications

(16 citation statements)

References 150 publications

(185 reference statements)

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“…Taking into account the link between systemic inflammation and CV diseases, it is conceivable that controlling inflammation by systemic agents may positively impact the CV risk in PsD ( 73 , 74 ). It is now well demonstrated that conventional synthetic agents such as methotrexate (MTX), but also TNFi, improve the CV burden of patients with RA ( 75 ).…”

Section: Clinical Implications Of Cardiometabolic Conditions In Psdmentioning

confidence: 99%

The cardiometabolic conditions of psoriatic disease

2022

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Psoriasis (PsO) and psoriatic arthritis (PsA), together known as psoriatic disease (PsD), are immune-mediated diseases with a chronic and relapsing course that affect the skin, the joints or both. The pathophysiology of PsO is complex and involves abnormal expression of keratinocytes and infiltration of the skin with dendritic cells, macrophages, neutrophils and T lymphocytes. Around 30% of patients with PsO develop arthritis with axial and/or peripheral manifestations. Both PsO and PsA share similar Th1- and Th17-driven inflammation, with increased production of inflammatory cytokines, including TNFα, IFN-γ, IL-17, IL-22, IL-23 in the skin and the synovial membrane. PsD is associated with a high burden of cardiometabolic diseases such as hypertension, diabetes, dyslipidemia, obesity, metabolic syndrome and cardiovascular (CV) complications as compared to the general population. These comorbidities share common immunopathogenic pathways linked to systemic inflammation, and are associated with the extent and severity of the disease. Morever, they can influence treatment outcomes in PsD. In this short review, we summarize the available evidence on the epidemiology, clinical aspects and mechanisms of cardiometabolic conditions in patients with PsD. We also discuss the impact of targeted treatments such as methotrexate and biological agents on these cardiometabolic conditions.

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Section: Clinical Implications Of Cardiometabolic Conditions In Psdmentioning

confidence: 99%

The cardiometabolic conditions of psoriatic disease

2022

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“…Based on our findings, we believe that the preliminary assessment of comorbidities with routine dermatological investigations in psoriatic patients is essential to prevent possible cardiovascular mortalities. The recommended guidelines for the screening of cardiovascular comorbidities in psoriatic patients is provided by the National Psoriasis Foundation and the American Heart Association [32] (Table 5).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular comorbidities in patients with a severe form of psoriasis: A case-controlled study assessing clinical, biochemical, and radiological parameters

Akshay¹,

Harikishan²

2022

Our Dermatol Online

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Background: Psoriasis is a common, chronic, inflammatory, and proliferative disorder of the skin, and is associated with elevated lipid levels and exaggerated inflammatory status, which may lead to cardiovascular morbidities and mortalities. Aims: The aim was to estimate the cardiovascular risk profile among psoriatic patients when compared to controls. Settings and Design: This was a case-controlled study performed at a tertiary-care hospital. Methods and Material: One hundred patients with severe psoriasis were evaluated for clinical, biochemical, electrocardiographic, and radiological signs of cardiovascular comorbidities and were compared with one hundred age- and sex-matched controls. Statistical Analysis: IBM Corp. Released 2015. IBM SPSS Statistics for Windows, version 23.0. Armonk, NY: IBM Corp. Results: Males predominated (1.27:1), with the most common age group being 31 to 40 years old. Smoking and alcohol consumption were common among the psoriatic patients (odds ratio = 4.14 and 2.38, respectively). The mean PASI score among the cases was 26.19 ± 10.8, with an extreme effect on their quality of life. The psoriatic patients presented with independent cardiovascular risk factors, including systolic hypertension (148.67 ± 10.91 mm of Hg), elevated fasting blood sugars (129.46 ± 35.64 mg/dL), hypercholesterolemia (152.34 ± 44.56 mg/dL), and hypertriglyceridemia (186.29 ± 29.45 mg/dL), with metabolic syndrome among 41% of the cases. On the electrocardiogram, the P wave was elevated (22%) and the QTc interval was prolonged (20%) among the cases. On high-resolution ultrasonography, the intima–media of the carotid arteries were thickened (0.944 ± 0.132 mm), indicating subclinical atherosclerosis in the psoriatic patients. Conclusions: Early detection and periodic screening for cardiovascular risk factors among psoriatic patients and aggressive therapeutic management are recommended to reduce the disease burden and improve their quality of life.

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“…Beside the evidence of the psoriasis-CVD crosstalk, several efforts have been made to understand whether a systemic treatment of psoriasis may lead to the control of the systemic inflammation associated with the skin manifestations, and to limit the risk of CV events ( 55 , 76 – 78 ). The 2021 Group for Research and Assessment of Psoriasis and Psoriatic arthritis (GRAPPA) treatment recommendations for psoriasis are summarized in ( 79 ).…”

Section: Targeting Key Inflammatory Pathways To Reduce CV Risk In Pso...mentioning

confidence: 99%

Psoriasis and Cardiovascular Diseases: An Immune-Mediated Cross Talk?

et al. 2022

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Psoriasis is a chronic immune-mediated inflammatory skin disease, characterized by well-demarcated scaly, erythematous, infiltrated plaques. The cutaneous-to-systemic expansion of the inflammation in psoriasis leads to the concept of “psoriatic march” or “inflammatory skin march”. Accordingly, psoriasis is thought to be a systemic inflammatory disease associated with numerous comorbidities. Indeed, it’s currently considered an independent risk factor for cardiovascular diseases. Here, we discuss the current knowledge on TNF-α and IL-23/IL-17 mediated pathways linking the psoriatic plaque to the cardiovascular compartment. We further argue the possible involvement of the endothelial compartment in the psoriatic plaque- cardiovascular system crosstalk.

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Cardiometabolic Comorbidities in Patients With Psoriasis: Focusing on Risk, Biological Therapy, and Pathogenesis

Cited by 25 publications

References 150 publications

The cardiometabolic conditions of psoriatic disease

The cardiometabolic conditions of psoriatic disease

Cardiovascular comorbidities in patients with a severe form of psoriasis: A case-controlled study assessing clinical, biochemical, and radiological parameters

Psoriasis and Cardiovascular Diseases: An Immune-Mediated Cross Talk?

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