Interleukin-17 Inhibitors and Early Major Adverse Cardiovascular Events.

Area of Science:

• Cardiovascular Medicine
• Dermatology
• Immunology

Background:

• The cardiovascular impact of biologics for psoriasis is not fully understood.
• Inhibition of the T-helper 17 cell pathway may destabilize atherosclerotic plaques, potentially increasing major adverse cardiovascular events (MACEs).

Purpose of the Study:

• To assess if initiating interleukin (IL)-17A inhibitors triggers MACEs.
• To evaluate the association between IL-17A inhibitor initiation and MACEs, using tumor necrosis factor (TNF)-α inhibitors as a comparator.

Main Methods:

• A case-time-control study utilized the French National Health Insurance database (2016-2021).
• Included patients initiating IL-17A inhibitors (secukinumab, ixekizumab, brodalumab) or TNF-α inhibitors (adalimumab, etanercept).
• Assessed MACE risk in the 6 months post-initiation compared to a prior 6-month reference period.

Main Results:

• Among 34,241 individuals on IL-17A inhibitors, 381 MACEs were analyzed.
• Initiation of IL-17A inhibitors showed no significant association with MACEs (OR, 1.40 [95% CI, 0.77-2.54]) compared to TNF-α inhibitors.
• Results remained consistent across sensitivity analyses and patient cardiovascular risk levels.

Conclusions:

• No significant association was found between MACEs and the initiation of IL-17A inhibitors.
• The study suggests IL-17A inhibitors are not linked to increased cardiovascular risk in psoriasis patients.
• A modest risk increase cannot be entirely excluded, warranting continued monitoring.