The effect of tumor necrosis factor inhibitor therapy on the incidence of myocardial infarction in patients with psoriasis: a retrospective study

Shaaban, Dalia; Al-Mutairi, Nawaf

doi:10.1080/09546634.2016.1254145

Cited by 15 publications

(17 citation statements)

References 36 publications

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“…Compared to patients who received topical therapy, psoriasis patients treated with TNF-α inhibitors showed a significant decrease in the risk of myocardial infarction (hazard ratio 0.50) [ 263 ]. Other studies have also confirmed the beneficial effects of TNF-α inhibitors in reducing the risk of myocardial infarction in psoriasis patients [ 264 , 265 , 266 , 270 , 271 , 272 ]. In addition, a number of studies have shown that treatment of psoriasis patients with TNF-α inhibitors leads to decreased risk of cardiovascular events compared to methotrexate, and greater risk reduction was found with longer duration of anti-TNF-α treatment [ 267 , 273 ].…”

Section: Effects Of Anti-psoriasis Therapies On Cardiovascular Commentioning

confidence: 77%

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Lan

2017

IJMS

152

121

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Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment.

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Section: Effects Of Anti-psoriasis Therapies On Cardiovascular Commentioning

confidence: 77%

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Lan

2017

IJMS

152

121

View full text Add to dashboard Cite

show abstract

“…For example, treatment with TNF inhibitors in rheumatoid arthritis, an overt inflammatory disease, is associated with a decreased risk of cardiovascular events 182–187 . Treatment with TNF inhibitors in psoriasis is also associated with decreased incidence of major adverse cardiac events 186,188,189 . However, anti-inflammatory treatment does not always yield beneficial effects.…”

Section: Consequences Of Inflammageing For Cvdmentioning

confidence: 99%

Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty

2018

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Most older individuals develop inflammageing, a condition characterized by elevated levels of blood inflammatory markers that carries high susceptibility to chronic morbidity, disability, frailty, and premature death. Potential mechanisms of inflammageing include genetic susceptibility, central obesity, increased gut permeability, changes to microbiota composition, cellular senescence, NLRP3 inflammasome activation, oxidative stress caused by dysfunctional mitochondria, immune cell dysregulation, and chronic infections. Inflammageing is a risk factor for cardiovascular diseases (CVDs), and clinical trials suggest that this association is causal. Inflammageing is also a risk factor for chronic kidney disease, diabetes mellitus, cancer, depression, dementia, and sarcopenia, but whether modulating inflammation beneficially affects the clinical course of non-CVD health problems is controversial. This uncertainty is an important issue to address because older patients with CVD are often affected by multimorbidity and frailty — which affect clinical manifestations, prognosis, and response to treatment — and are associated with inflammation by mechanisms similar to those in CVD. The hypothesis that inflammation affects CVD, multimorbidity, and frailty by inhibiting growth factors, increasing catabolism, and interfering with homeostatic signalling is supported by mechanistic studies but requires confirmation in humans. Whether early modulation of inflammageing prevents or delays the onset of cardiovascular frailty should be tested in clinical trials.

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“…On the other hand, TNF-α inhibitors have been shown to significantly reduce the risk of myocardial infarction in patients with psoriasis compared with topical treatment. 13 In this study, infliximab was discontinued in two patients because of cerebrovascular disease in one patient and myocardial infarction in another. We think that this situation, which is contrary to the literature, may be related to the fact that both patients are elderly and diabetic and infliximab is more frequently preferred in our clinic.…”

Section: Discussionmentioning

confidence: 98%

Biological Drug Use in Patients with Psoriasis: Our Clinical Experiences

Nazik¹,

Öztürk²,

Mülayim³

2018

Turkiye Klinikleri J Dermatol

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The effect of tumor necrosis factor inhibitor therapy on the incidence of myocardial infarction in patients with psoriasis: a retrospective study

Abstract: The use of TNF inhibitors in psoriasis showed a significant reduction in the risk of MI compared with topical agents and a non-significant reduction compared with MTX. Responders to TNF inhibitor therapy showed a reduction in MI rate compared with non-responders.

Cited by 15 publications

References 36 publications

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty

Biological Drug Use in Patients with Psoriasis: Our Clinical Experiences

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