Related Experiment Video

Updated: Jan 16, 2026

Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
02:28

Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients

Published on: March 1, 2024

771

Choice of Biologic Immunotherapy for Psoriasis or Psoriatic Arthritis and Its Association With Risk of Major Adverse

Jack Geiger1, Bonit Gill1, Jean Liew2

  • 1J. Geiger, DO, B. Gill, DO, M. Putman, MD, S. Singla, MD, Medical College of Wisconsin, Milwaukee, Wisconsin.

The Journal of Rheumatology
|October 1, 2025
PubMed

Insights

Patients with psoriasis or psoriatic arthritis using biologic disease-modifying antirheumatic drugs (bDMARDs) face similar risks of major adverse cardiac events (MACE) regardless of the drug class. Cardiovascular risk should not influence the choice of bDMARD for these patients.

Area of Science:

  • Rheumatology
  • Cardiology
  • Pharmacology

Background:

  • Psoriasis (PsO) and psoriatic arthritis (PsA) patients have increased risk of major adverse cardiac events (MACE).
  • Biologic disease-modifying antirheumatic drugs (bDMARDs) are used to treat PsO and PsA, but their comparative effect on MACE risk is unclear.

Purpose of the Study:

  • To investigate if the risk of MACE differs among various bDMARD classes in patients with PsO/PsA.
  • To compare the cardiovascular safety profiles of different bDMARDs in this patient population.

Main Methods:

  • Retrospective cohort study using the TriNetX database.
  • Identified new users of tumor necrosis factor inhibitors (TNFi), IL-17A inhibitors (IL-17i), IL-23 inhibitors (IL-23i), or IL-12/23 inhibitors (IL-12/23i).
  • Weighted multinomial Cox proportional hazards regression was used to calculate time-dependent MACE risk, with TNFi as the referent group. Bias was assessed using negative control outcomes.

Main Results:

  • 32,758 new bDMARD users with PsO/PsA were identified.
  • The adjusted risk of MACE was comparable across IL-17i (aHR 0.98), IL-23i (aHR 0.84), and IL-12/23i (aHR 1.08) compared to TNFi.
  • Subset analyses and negative control outcomes supported the primary findings, indicating adequate control of bias.

Conclusions:

  • The risk of MACE does not significantly vary between different classes of bDMARDs in patients with PsO/PsA.
  • Cardiovascular risk should not be a primary factor when selecting a bDMARD for patients with PsO/PsA.
Abstract

Keywords:
biologic therapycardiovascular diseasesimmunosuppressive agentspsoriasispsoriatic arthritis

More Related Videos

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

39.4K
Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

817

Related Concept Videos

Psychoneuroimmunology: Cardiovascular Disease01:27

Psychoneuroimmunology: Cardiovascular Disease

Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
402
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
492
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
289
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
175
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
492
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
313