Biologic Therapy for psoriasis reduces coronary plaques : Study

Psoriasis is a chronic inflammatory skin disease related to inherited genes.The common therapy for the disease includes biologic agents like Tumor necrosis factor-alpha (TNF-alpha) inhibitors and Interleukin inhibitors.

In a first-in-human observational study, it has been found that Common therapy options for Psoriasis can help reduce coronary plaques. Further, it not only reduces the volume of the plaque, but also the plaque becomes less inflammatory over time harboring fewer characteristics prone to rupture and cause a heart attack. Evidence marks a significant reduction in adverse cardiovascular events targeting interleukin-1 beta (IL1B), a cytokine that is central to the inflammatory response.

Astudy in this regard was presented by the Research Fellow Youssef Elnabawi from the National Heart, Lung, and Blood Institute in Bethesda, Maryland at the Society for Cardiovascular Angiography and Interventions (SCAI) Scientific Sessions 2018

Dr.Nehal N. Mehta and associates conducted the research to identify if treatment of the inflammatory skin disease potentially affected coronary plaque.

Anti-tumor necrosis factor (TNF) agents are commonly used, biologic, and FDA-approved immunomodulatory treatment options for PSO. More than 80 consecutive patients of middle age were stratified by biologic treatment (predominantly anti-TNF; n=57) and non-biologic treatment (n= 27). Non-calcified burden (NCB), plaque volume (PV), and maximal artery stenosis in the proximal vessels (diameter>2mm) were blindly assessed based on coronary CT angiography using dedicated software.

At one-year, the plaque volume in the biologic treated group decreased by 40 percent, a finding not observed in those without treatment. Trends in NCB and maximal stenosis were significant and consistent with PV in both groups. Furthermore, change in PV was also positively associated with a change in IL1B ), even after adjustment for traditional cardiovascular risk factors and statin use.

"To see a reduction in coronary plaque after just one year of biologic therapy alone is incredible and very assuring. It's the first time we're seeing treatment of a skin disease with biologic therapy have an impact specifically on plaque in the coronary," said Nehal N. Mehta, MD MSCE FAHA, the Principal Investigator of the study from the National Heart, Lung, and Blood Institute.

"Our study results further emphasize the importance of patients maintaining and treating psoriasis to decrease the risks of adverse cardiovascular events occurring. This also opens the door for us to look at other disease states and see how anti-inflammatory therapy options could impact coronary plaque over time."

The author suggested that further randomized study has to be done in this area to better understand how treatment with anti-inflammatory medications modulates coronary plaque volume over time.

It is the first-in-human observational study demonstrating that treating remote inflammation in the body can modulate coronary disease

The study was presented by the Research Fellow Youssef Elnabawi from the National Heart, Lung, and Blood Institute in Bethesda, Maryland at the Society for Cardiovascular Angiography and Interventions (SCAI) Scientific Sessions 2018

It was published in the journal Catheterization and Cardiovascular Intervention