Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis

J. J. Wu; A. A. Joshi; S. P. Reddy; M. Batech; A. Egeberg; O. Ahlehoff; N. N. Mehta

doi:10.1111/jdv.14951

Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis

J. J. Wu, A. A. Joshi, S. P. Reddy, M. Batech, A. Egeberg, O. Ahlehoff, N. N. Mehta

Research output: Contribution to journal › Article › peer-review

37 Scopus citations

Abstract

Background: Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. Objective: To determine whether tumour necrosis factor inhibitor (TNFi) therapy is associated with decreased major adverse cardiovascular events (MACE) in patients with psoriasis. Methods: In this retrospective cohort study using the KPSC health plan, patients had at least three ICD-9 codes for psoriasis and no antecedent MACE codes. Propensity score-adjusted multivariable Cox regression assessed hazard ratios (HR) of MACE associated with TNFi use. Results: After adjusting for cardiovascular risk factors, the TNFi cohort had significantly lower MACE HR compared with the topical cohort (HR, 0.80; 95% CI, 0.66–0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort (HR, 1.19 (95% CI, 0.99–1.42)). Conclusions: We observed significantly lower MACE risk in patients with psoriasis receiving TNFi compared to topical or oral/phototherapy agents. TNFi therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.

Original language	English
Pages (from-to)	1320-1326
Number of pages	7
Journal	Journal of the European Academy of Dermatology and Venereology
Volume	32
Issue number	8
DOIs	https://doi.org/10.1111/jdv.14951
State	Published - Aug 2018
Externally published	Yes

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title = "Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis",

abstract = "Background: Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. Objective: To determine whether tumour necrosis factor inhibitor (TNFi) therapy is associated with decreased major adverse cardiovascular events (MACE) in patients with psoriasis. Methods: In this retrospective cohort study using the KPSC health plan, patients had at least three ICD-9 codes for psoriasis and no antecedent MACE codes. Propensity score-adjusted multivariable Cox regression assessed hazard ratios (HR) of MACE associated with TNFi use. Results: After adjusting for cardiovascular risk factors, the TNFi cohort had significantly lower MACE HR compared with the topical cohort (HR, 0.80; 95% CI, 0.66–0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort (HR, 1.19 (95% CI, 0.99–1.42)). Conclusions: We observed significantly lower MACE risk in patients with psoriasis receiving TNFi compared to topical or oral/phototherapy agents. TNFi therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.",

author = "Wu, {J. J.} and Joshi, {A. A.} and Reddy, {S. P.} and M. Batech and A. Egeberg and O. Ahlehoff and Mehta, {N. N.}",

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year = "2018",

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Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis. / Wu, J. J.; Joshi, A. A.; Reddy, S. P. et al.
In: Journal of the European Academy of Dermatology and Venereology, Vol. 32, No. 8, 08.2018, p. 1320-1326.

Research output: Contribution to journal › Article › peer-review

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T1 - Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis

AU - Wu, J. J.

AU - Joshi, A. A.

AU - Reddy, S. P.

AU - Batech, M.

AU - Egeberg, A.

AU - Ahlehoff, O.

AU - Mehta, N. N.

PY - 2018/8

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N2 - Background: Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. Objective: To determine whether tumour necrosis factor inhibitor (TNFi) therapy is associated with decreased major adverse cardiovascular events (MACE) in patients with psoriasis. Methods: In this retrospective cohort study using the KPSC health plan, patients had at least three ICD-9 codes for psoriasis and no antecedent MACE codes. Propensity score-adjusted multivariable Cox regression assessed hazard ratios (HR) of MACE associated with TNFi use. Results: After adjusting for cardiovascular risk factors, the TNFi cohort had significantly lower MACE HR compared with the topical cohort (HR, 0.80; 95% CI, 0.66–0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort (HR, 1.19 (95% CI, 0.99–1.42)). Conclusions: We observed significantly lower MACE risk in patients with psoriasis receiving TNFi compared to topical or oral/phototherapy agents. TNFi therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.

AB - Background: Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. Objective: To determine whether tumour necrosis factor inhibitor (TNFi) therapy is associated with decreased major adverse cardiovascular events (MACE) in patients with psoriasis. Methods: In this retrospective cohort study using the KPSC health plan, patients had at least three ICD-9 codes for psoriasis and no antecedent MACE codes. Propensity score-adjusted multivariable Cox regression assessed hazard ratios (HR) of MACE associated with TNFi use. Results: After adjusting for cardiovascular risk factors, the TNFi cohort had significantly lower MACE HR compared with the topical cohort (HR, 0.80; 95% CI, 0.66–0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort (HR, 1.19 (95% CI, 0.99–1.42)). Conclusions: We observed significantly lower MACE risk in patients with psoriasis receiving TNFi compared to topical or oral/phototherapy agents. TNFi therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.

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Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis

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