Effect of biologics targeting interleukin‐23/‐17 axis on subclinical atherosclerosis: results of a pilot study

Abstract

Summary Background Psoriasis is associated with an increased risk of developing atherosclerotic vascular disease. The hypothesis that treatment of the skin inflammation may decrease the risk of developing atherosclerosis and consequently, cardiovascular disease, is currently a focus of significant attention. Aim To assess the effect of biologic drugs targeting the interleukin (IL)‐23/IL‐17 axis on selected subclinical atherosclerosis parameters in patients with psoriatic disease. Methods In a series of patients with moderate to severe psoriasis who were eligible for biologic therapy, pulse wave velocity (PWV) and intima–media thickness (IMT) were determined before therapy and after 6 months of treatment with biologics (ustekinumab, secukinumab, ixekizumab). Results After 6 months of treatment, a marked clinical improvement of skin lesions was observed in all patients. No significant changes in PWV or IMT values were observed before (8.59 ± 1.96 mm and 0.54 ± 0.9 mm, respectively) and after 6 months (8.89 ± 2.02 mm and 0.53 ± 0.9 mm) of therapy (P = 0.16 and P = 0.74). Conclusions Systemic treatment of patients with a psoriatic disease with biologics targeting the IL‐23/IL‐17 axis has a possibly neutral effect on atherosclerosis. Additional studies are needed to assess the impact of newer biologic treatments on atherosclerosis.

Impact of Interleukin-17 Inhibitor Therapy on Arterial Intima-media Thickness among Severe Psoriatic Patients

“…The improvements in patients' clinical characteristics are shown in Table 3. The median initial PASI value for the overall study population was 18 (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). After 6 months of treatment with anti-IL-17 therapies, the PASI score significantly decreased (p < 0.001) to a median value of 0 (0-4).…”

“…In our previous study, we observed a significant improvement of the carotid and brachial IMT (bIMT) values among moderate-to-severe psoriatic patients after 6 months of TNF inhibitor treatment [ 9 , 13 ]. In contrast, other studies found no significant improvement in cIMT values by using ustekinumab, secukinumab, ixekizumab, and adalimumab therapies [ 14 , 15 ].…”

“…We also found significant changes in the quality-oflife scores (DLQI and EQ VAS). The median initial DLQI and EQ VAS values were 17 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) and 60 (50-80), respectively. In the 6 th months of the therapies, DLQI improved significantly (p < 0.001) to a median value of 0, and EQ VAS significantly increased (p < 0.001) to a median value of 90.…”

Antibody-Based Therapeutics for Atherosclerosis and Cardiovascular Diseases

“…These results demonstrated the effectiveness of ustekinumab in alleviating the symptoms of patients with moderate-to-severe Crohn’s disease [ 136 ]. A small-scale pilot study examined the atherosclerosis parameters in patients with psoriasis treated with ustekinumab, and reported that while there was a noticeable relief of skin lesions after 6 months of treatment, there was no notable change in the pulse wave velocity and intima-media thickness [ 137 ].…”

Assessing the Short-Term Efficacy and Safety of Guselkumab for Moderate-to-Severe Plaque Psoriasis: Meta-Analysis of Randomized Controlled Trials

“…At present, the main inhibitors for the treatment of psoriasis are IL-23 inhibitors, IL-17 inhibitors, and TNF- α inhibitors. The central role of interleukin-23/interleukin-17 (IL-23/IL-17) axis in the pathogenesis of psoriasis and the effectiveness of its targeted therapy have been confirmed by numerous studies [ 6 , 7 ]. IL-23 belongs to the IL-12 cytokine family.…”