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Risk of major cardiovascular events in patients with psoriasis receiving biologic therapies: a prospective cohort

W Rungapiromnan1, K J Mason2, M Lunt2

  • 1Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

Journal of the European Academy of Dermatology and Venereology : JEADV
|October 22, 2019
PubMed

Insights

This study found no significant differences in major cardiovascular events (CVEs) among patients with psoriasis treated with ustekinumab, etanercept, adalimumab, or methotrexate. Further research is needed to confirm these findings with longer follow-up periods.

Area of Science:

  • Dermatology
  • Cardiology
  • Pharmacology

Background:

  • The cardiovascular safety of biologic therapies for psoriasis remains unclear.
  • Psoriasis is associated with an increased risk of cardiovascular disease.

Purpose of the Study:

  • To compare the risk of major cardiovascular events (CVEs) in patients with chronic plaque psoriasis treated with adalimumab, etanercept, or ustekinumab.
  • To evaluate the comparative risk of CVEs between different biologic therapies and methotrexate.

Main Methods:

  • A large prospective cohort study was conducted using the British Association of Dermatologists Biologics and Immunomodulators Register.
  • Comparative risk of major CVEs was analyzed using propensity score overlap weights to balance covariates.
  • Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for ustekinumab vs. tumor necrosis factor-α inhibitors (TNFi), and other comparisons including methotrexate.

Main Results:

  • 5468 biologic-naïve patients were included in the main analysis (951 ustekinumab, 1313 etanercept, 3204 adalimumab).
  • Secondary analyses included 2189 patients receiving methotrexate.
  • No significant differences in the risk of major CVEs were observed between ustekinumab, TNFi (adalimumab, etanercept), and methotrexate (adjusted HRs ranging from 0.81 to 1.05).

Conclusions:

  • This study found no significant differences in the risk of major cardiovascular events (CVEs) among patients with chronic plaque psoriasis treated with adalimumab, etanercept, ustekinumab, or methotrexate.
  • Longer-term follow-up studies are necessary to further investigate the potential cardiovascular effects of these biologic therapies.
Abstract

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