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Updated: Jun 26, 2025
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review
Hitaishi Mehta1, Tarun Narang1, Sunil Dogra1
1Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Insights
Psoriasis is linked to cardiovascular disease (CVD) through shared genetic and immune pathways. Certain treatments may reduce CVD risk, but more research is needed for comprehensive management.
Area of Science:
- Dermatology and Cardiology
- Immunology and Genetics
Background:
- Psoriasis is a chronic inflammatory skin disease with significant links to cardiovascular diseases (CVD).
- The interplay involves genetic factors, immune responses, and adipose tissue dysfunction, extending beyond traditional CVD risk factors.
Purpose of the Study:
- To review the complex relationship between psoriasis and the cardiovascular system.
- To explore genetic links, immune pathways, and treatment implications for cardiovascular risk in psoriasis patients.
Main Methods:
- Comprehensive literature review of studies on psoriasis and cardiovascular comorbidities.
- Analysis of genetic polymorphisms (e.g., IL-23, TNF-α), immune pathways, and treatment effects on cardiovascular outcomes.
Main Results:
- Psoriasis-specific genetic factors (IL-23, TNF-α) are associated with CVD.
- TNF inhibitors (TNFi) and methotrexate may reduce cardiovascular risk; IL-12/23 inhibitors' role is uncertain.
- IL-17 and IL-23 inhibitors show emerging safety and efficacy in patients with CVD.
Conclusions:
- Understanding the psoriasis-CVD link requires a multidisciplinary approach involving dermatology, rheumatology, and cardiology.
- Further research is needed on screening guidelines, disease phenotypes, and treatment hierarchies for cardiovascular risk management in psoriasis.
Abstract:
Psoriasis, a prevalent chronic inflammatory skin disorder affecting 2-3% of the global population, has transcended its dermatological confines, revealing a profound association with cardiovascular diseases (CVD). This comprehensive review explores the intricate interplay between psoriasis and cardiovascular system, delving into genetic links, immune pathways, and adipose tissue dysfunction beyond conventional CVD risk factors. The pathophysiological connections unveil unique signatures, distinct from other inflammatory skin conditions, in particular psoriasis-specific genetic polymorphisms in IL-23 and TNF-α have consistently been linked to CVD. The review navigates the complex landscape of psoriasis treatments, addressing challenges and future directions in particular relevance to CVDs in psoriasis. Therapeutic interventions, including TNF inhibitors (TNFi), present promise in reducing cardiovascular risks, and methotrexate could constitute a favourable choice. Conversely, the relationship between IL-12/23 inhibitors and cardiovascular risk remains uncertain, while recent evidence indicates that Janus kinase inhibitors may not carry CVD risks. Emerging evidence supports the safety and efficacy of IL-17 and IL-23 inhibitors in patients with CVDs, hinting at evolving therapeutic paradigms. Lifestyle modifications, statins, and emerging therapies offer preventive strategies. Dedicated screening guidelines for CVD risk assessment in psoriasis are however lacking. Further, the impact of different disease phenotypes and treatment hierarchies in cardiovascular outcomes remains elusive, demanding ongoing research at the intersection of dermatology, rheumatology, and cardiology. In conclusion, unraveling the intricate connections between psoriasis and CVD provides a foundation for a holistic approach to patient care. Collaboration between specialties, advancements in screening methodologies, and a nuanced understanding of treatment impacts are essential for comprehensive cardiovascular risk management in individuals with psoriasis.
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