Studying the effect of systemic and biological drugs on intima-media thickness in patients suffering from moderate and severe psoriasis

J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1492-1498. doi: 10.1111/jdv.14841. Epub 2018 Mar 30.

Abstract

Background: Psoriasis has been related to a large number of cardiovascular risk factors such as hypertension, diabetes mellitus and arteriosclerosis. The increased carotid intima-media thickness (IMT) could be considered to be a marker of generalized arteriosclerosis.

Objective: To assess the effect of systemic and biological drugs on psoriatic patients' carotid IMT.

Methods: A prospective study was performed. We studied 53 patients with moderate and severe psoriasis from our psoriasis dermatological unit, analysing lipid and glucose metabolism and performing a carotid IMT sonography before introduction of systemic and biological drugs. After that, we performed an 8-month closely analytic and sonographic follow-up.

Results: The IMT of the patients with psoriasis treated with biological drugs tended to decrease, although this occurrence was not statistically significant (P = 0.086). The subgroup analysis revealed that patients treated with methotrexate (P = 0.045) and anti-IL-12/23 (P = 0.010) presented a decrease in their IMT levels. This analysis also showed a decrease in glycaemia and insulin levels in patients treated with TNF-alpha inhibitors and ustekinumab.

Conclusions: Our study suggests that the carotid IMT may benefit from treatment with biological drugs, particularly anti-IL-12/23 and methotrexate in patients suffering from moderate and severe psoriasis. However, larger longitudinal studies should be performed to fully confirm these results.

MeSH terms

  • Adult
  • Biological Products / therapeutic use
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Carotid Intima-Media Thickness*
  • Dermatologic Agents / pharmacology*
  • Dermatologic Agents / therapeutic use
  • Female
  • Humans
  • Insulin / blood
  • Lipoproteins, LDL / blood
  • Longitudinal Studies
  • Male
  • Methotrexate / pharmacology*
  • Methotrexate / therapeutic use
  • Middle Aged
  • Prospective Studies
  • Psoriasis / drug therapy*
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tunica Intima / drug effects
  • Tunica Media / drug effects
  • Ustekinumab / pharmacology*
  • Ustekinumab / therapeutic use

Substances

  • Biological Products
  • Blood Glucose
  • Dermatologic Agents
  • Insulin
  • Lipoproteins, LDL
  • Tumor Necrosis Factor-alpha
  • Ustekinumab
  • Methotrexate