Cardiovascular outcomes and systemic anti‐inflammatory drugs in patients with severe psoriasis: 5‐year follow‐up of a Danish nationwide cohort

Abstract

Systemic anti-inflammatory treatment with methotrexate was associated with significantly lower rates of cardiovascular events during long-term follow-up compared to patients treated with other antipsoriatic therapies. The treatment strategy in patients with severe psoriasis may have an impact on cardiovascular outcomes and randomized trials to evaluate the cardiovascular safety and efficacy of systemic antipsoriatic therapies are called for.

The Effect of TNF Inhibitors on Cardiovascular Events in Psoriasis and Psoriatic Arthritis: an Updated Meta-Analysis

“…The five published studies [6,[15][16][17][18] that included a total of 49,795 patients were enrolled. The mean duration of followup was 38 months.…”

Management of Cardiovascular Risk in Patients with Chronic Inflammatory Diseases: Current Evidence and Future Perspectives

“…The inflammatory cytokines, and other inflammatory mediators, influence all stages of atherosclerosis development, from early atheroma formation to superimposed acute thrombus development, leading to CVD events such as MI. Indeed, this hypothesis seems to be supported by studies suggesting that inflammation control lowers the CID-related CVD risk [15][16][17][18][19][20][21]47]. These observations have led to the hypothesis that CVD risk in CID patients may be reduced through firm control of the chronic inflammatory processes.…”

“…At the same time, the role of inflammation as a key player in atherogenesis has become evident [12][13][14]. Consequently, the possibility of reducing inflammation as a means to preventing CVD in these patients has gained considerable interest in recent years [15][16][17][18][19][20][21]. Also, the repeated observations of increased CV risk in patients with CID have started an ongoing discussion on the need for a multidisciplinary approach and dedicated guidelines on CVD prevention in these patients.…”

Psoríase e Doença Cardiovascular: Impacto da Terapêutica com Inibidores do TNF-alfa

“…50 Após uma aná-lise de multivariáveis, observou-se que os doentes tratados com metotrexato apresentaram um risco significativamente inferior de morte cardiovascular, EM e AVC comparativamente ao grupo de doentes tratados com outras terapêu-ticas (HR 0,53; 95% IC, 0,34-0,83, p = 0,005), e que os fármacos biológicos tinham um efeito protetor comparável, mas estatisticamente não significativo (HR, 0,58; 95% IC, 0,30-1,10, p = 0,10) (Tabela 1). Avaliando a taxa incidên-cia de eventos cardiovasculares dos inibidores do TNF-a e da interleucina 12/23 separadamente verificou-se que apenas os inibidores do TNF-a se associaram a diminuição do risco cardiovascular (HR 0,46; 95% IC 0,22-0,98, p = 0,04).…”