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Biologics: improvement beyond the skin?

Psoriasis is a chronic immune-mediated  inflammatory skin disease. Patient with psoriasis typically present with erythematous scaling patches and plaques on the elbows, knees, scalp and buttocks.  Up to 30 percent of patients who have psoriasis will develop psoriatic arthritis. It has been found that patients who have psoriasis are at an increased risk of comorbidities including  cancer, diabetes, metabolic syndrome, depression, liver disease, kidney disease and cardiovascular disease. It has been reported the leading cause of death for patients with severe psoriatic arthritis is cardiovascular disease.

With the advent of biologic therapies, many patients with psoriatic arthritis and psoriasis have found significant improvement of their disease.  A recent study in JAMA Cardiology is finding biologic therapy may also improve psoriasis patients’ risk for cardiovascular disease.  In this study, the researchers utilized perivascular fat attenuation index (FAI), a novel imaging biomarker that assesses coronary inflammation by mapping spatial changes of perivascular fat composition via coronary computed tomography angiography (CCTA).

Patients in the study who were using biologic therapy  for treatment of their psoriasis were found to have a significant decrease in FAI at one year. Psoriasis patients who were not on biology therapy had no change in their FAI at one year.  The findings were consistent among patients receiving different biologic agents, including anti–tumor necrosis factor α.   The authors of this study conclude biologic therapy for moderate to severe psoriasis was associated with reduced coronary inflammation assessed by perivascular FAI.

Byline: Sarah Patton, MSHS, PA-C
Posted August 21, 2019

Source: Elnabawi YA, Oikonomou EK, Dey AK, et al. Association of biologic therapy with coronary inflammation in patients with psoriasis as assessed by perivascular fat attenuation index. JAMA Cardiol. 2019: Published online July 31, 2019. doi:10.1001/jamacardio.2019.2589

 Adapted from original article