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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Published on: July 11, 2013

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Biologic Therapies and Major Cardiovascular Events in Psoriasis: Updated Systematic Review and Meta-analysis

Varitsara Mangkorntongsakul1, J S Joseph2, James P Pham3,4

  • 1Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Dermatology and Therapy
|October 28, 2025
PubMed

Insights

Biologic therapies for severe plaque psoriasis do not increase the risk of major adverse cardiovascular events (MACE). This systematic review found no significant difference in MACE risk between biologics and placebo in psoriatic patients.

Area of Science:

  • Dermatology and Immunology
  • Cardiology
  • Pharmacology

Background:

  • Psoriasis is frequently associated with cardiovascular disease.
  • Biologic therapies are effective for severe plaque psoriasis, but their cardiovascular safety is not fully understood.

Purpose of the Study:

  • To investigate the impact of biologic therapies on the risk of major adverse cardiovascular events (MACE) in patients with chronic plaque psoriasis.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) published up to May 10, 2022.
  • Included RCTs compared licensed biologic therapies with placebo or other biologics in adults with moderate-to-severe plaque psoriasis.
  • Adherence to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Main Results:

  • Analysis of 43 RCTs found no statistically significant difference in MACE risk between biologic therapies and placebo (Peto odds ratio [POR] 1.26, 95% CI 0.53-3.01, P=0.59).
  • Specific biologic classes, including TNF-alpha, IL-17, IL-12/23, and IL-23 inhibitors, did not show a significant association with increased MACE risk.

Conclusions:

  • Anti-psoriatic biologic therapies are not associated with an increased risk of MACE in patients with psoriasis.
  • Longer-term studies and post-marketing surveillance are necessary to fully elucidate the cardiovascular safety profile of these treatments.
Abstract

Keywords:
Biologic therapyCardiovascular diseaseMajor adverse cardiovascular events (MACE)Meta-analysisPsoriasisSystematic review

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