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

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
Journal	Journal of the European Academy of Dermatology and Venereology : JEADV
Volume	32
Issue number	8
Pages (from-to)	1320-1326
Number of pages	7
ISSN	0926-9959
DOIs	https://doi.org/10.1111/jdv.14951
Publication status	Published - Aug 2018

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

Access to Document

10.1111/jdv.14951

Cite this

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.
In: Journal of the European Academy of Dermatology and Venereology : JEADV, Vol. 32, No. 8, 08.2018, p. 1320-1326.

Research output: Contribution to journal › Journal article › Research › 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, vol. 32, no. 8, pp. 1320-1326. https://doi.org/10.1111/jdv.14951

@article{40824740eb874831a86d0eac8723ed1a,

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.",

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}",

note = "{\textcopyright} 2018 European Academy of Dermatology and Venereology.",

year = "2018",

month = aug,

doi = "10.1111/jdv.14951",

language = "English",

volume = "32",

pages = "1320--1326",

journal = "Journal of the European Academy of Dermatology and Venereology : JEADV",

issn = "0926-9959",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "8",

}

TY - JOUR

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

Y1 - 2018/8

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.

KW - Adalimumab/therapeutic use

KW - Administration, Cutaneous

KW - Administration, Oral

KW - Adult

KW - Anti-Inflammatory Agents/therapeutic use

KW - California/epidemiology

KW - Dermatologic Agents/administration & dosage

KW - Etanercept/therapeutic use

KW - Female

KW - Humans

KW - Immunosuppressive Agents/administration & dosage

KW - Infliximab/therapeutic use

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

U2 - 10.1111/jdv.14951

DO - 10.1111/jdv.14951

M3 - Journal article

C2 - 29573294

SN - 0926-9959

VL - 32

SP - 1320

EP - 1326

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

Abstract

Keywords

Access to Document

Fingerprint

Cite this