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

41 Citationer (Scopus)

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.

Originalsprog	Engelsk
Tidsskrift	Journal of the European Academy of Dermatology and Venereology : JEADV
Vol/bind	32
Udgave nummer	8
Sider (fra-til)	1320-1326
Antal sider	7
ISSN	0926-9959
DOI	https://doi.org/10.1111/jdv.14951
Status	Udgivet - aug. 2018

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10.1111/jdv.14951

Citationsformater

Wu, J. J., Joshi, A. A., Reddy, S. P., Batech, M., Egeberg, A., Ahlehoff, O., & Mehta, N. N. (2018). Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis. Journal of the European Academy of Dermatology and Venereology : JEADV, 32(8), 1320-1326. https://doi.org/10.1111/jdv.14951

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.
I: Journal of the European Academy of Dermatology and Venereology : JEADV, Bind 32, Nr. 8, 08.2018, s. 1320-1326.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Wu, JJ, Joshi, AA, Reddy, SP, Batech, M, Egeberg, A , Ahlehoff, O & Mehta, NN 2018, 'Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis', Journal of the European Academy of Dermatology and Venereology : JEADV, bind 32, nr. 8, s. 1320-1326. https://doi.org/10.1111/jdv.14951

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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.",

keywords = "Adalimumab/therapeutic use, Administration, Cutaneous, Administration, Oral, Adult, Anti-Inflammatory Agents/therapeutic use, California/epidemiology, Dermatologic Agents/administration & dosage, Etanercept/therapeutic use, Female, Humans, Immunosuppressive Agents/administration & dosage, Infliximab/therapeutic use, Male, Middle Aged, Myocardial Infarction/epidemiology, PUVA Therapy, Proportional Hazards Models, Protective Factors, Psoriasis/drug therapy, Retrospective Studies, Stroke/epidemiology, Tumor Necrosis Factor-alpha/antagonists & inhibitors",

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",

month = aug,

doi = "10.1111/jdv.14951",

language = "English",

volume = "32",

pages = "1320--1326",

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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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KW - Humans

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KW - Male

KW - Middle Aged

KW - Myocardial Infarction/epidemiology

KW - PUVA Therapy

KW - Proportional Hazards Models

KW - Protective Factors

KW - Psoriasis/drug therapy

KW - Retrospective Studies

KW - Stroke/epidemiology

KW - Tumor Necrosis Factor-alpha/antagonists & inhibitors

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DO - 10.1111/jdv.14951

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JO - Journal of the European Academy of Dermatology and Venereology : JEADV

JF - Journal of the European Academy of Dermatology and Venereology : JEADV

IS - 8

ER -

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

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