The cardiometabolic conditions of psoriatic disease

Abstract

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.

High burden of polypharmacy and comorbidity in persons with psoriatic arthritis: an analysis of claims data, stratified by age and sex

“…A well-controlled PsA helps to reduce secondary conditions such as depression, cardiovascular disease, osteoporosis or osteoarthritis, all of which occurred more frequently in PsA than in controls. Cardiometabolic diseases are associated with the extent and severity of PsA and they can influence treatment outcomes 28. As is the case with psoriasis,29 pharmacologically treated depression is more common in individuals with PsA compared with controls.…”

“…Cardiometabolic diseases are associated with the extent and severity of PsA and they can influence treatment outcomes. 28 As is the case with psoriasis, 29 pharmacologically treated depression is more common in individuals with PsA compared with controls. It is noticeable that the proportion of persons with PsA on bDMARD therapy decreases sharply with age.…”

Serum salusin-α and salusin-β levels in patients with psoriatic arthritis

“…Other manifestations, such as cardiovascular disease, metabolic syndrome and eye involvement may Reumatologia 2022; 60/5 also seen [4]. Salusins are endogenous bioactive peptides with hemodynamic and mitogenic activities [5].…”

Current developments and perspectives in psoriasis

“…54,55 The involvement of other organ systems (comorbidity) and provocation factors also influence the course of psoriasis as a systemic disease. [56][57][58][59] From these brief descriptions, it is clear that the pathophysiology of psoriasis is complex. It is becoming increasingly clear that the overall pattern of inflammatory mediators and cells, which may well shift in the (lifelong) course of the disease, is ultimately responsible for the individual manifestation.…”