Coronary artery plaque characteristics and treatment with biologic therapy in severe psoriasis: results from a prospective observational study

• DOI: 10.1093/cvr/cvz009
• Publication Date: 2019-01-12T15:09:50Z
• Authors: Youssef A Elnabawi; Amit K Dey; Aditya Goyal; Jacob W Groenendyk; Jonathan H Chung; Agastya D Belur; Justin Rodante; Charlotte L Harri...; Heather L Teague; Yvonne Baumer; Andrew Keel; Martin P Playford; Veit Sandfort; Marcus Y Chen; Benjamin Lockshin; Joel M Gelfand; David A Bluemke; Nehal N Mehta
• Keywords: Interquartile range

The use of biologic therapy has increased over the past decade well beyond primary autoimmune diseases. Indeed, a recent trial using an anti-IL-1beta antibody reduced second myocardial infarction (MI) in those who have had MI. Psoriasis is chronic inflammatory disease often treated with biologics when severe, associated risk MI, part driven by high-risk coronary plaque phenotypes computed tomography angiography (CCTA). We hypothesized that we would observe reduction inflammatory-driven plaque, including non-calcified burden and lipid-rich necrotic core after one-year compared non-biologic therapy.In prospective, observational study, 290 participants were recruited from 1 January 2013 through 31 October 2018 215 completing follow-up. Of 238, 121 consecutive treatment naïve at baseline included. A blinded reader (blinded to patient demographics, visit treatment) quantified total subcomponents (calcified non-calcified) three main vessels >2 mm dedicated software (QAngio, Medis, Netherlands). patients middle-aged [mean (standard deviation) age, 50.5 (12.1) years], mostly male (n = 70, 58%) low cardiovascular Framingham score [median (interquartile range, IQR), 3 (1-6)] moderate severe skin (IQR) Area Severity Index, PASI, 8.6 (5.3-14.0)]. Biologic was 6% (P 0.005) 0.03), no effect on fibrous 0.71). Decrease group significant slow progression (Δ, -0.07 mm2 vs. 0.06 mm2; P 0.02) adjustment for traditional factors (β 0.20, 0.02).In this demonstrate psoriasis favourable modulation indices CCTA. These findings highlight importance systemic inflammation artery support conduct larger, randomized trials.