Joseph Joseph, Kelvin Truong, Serigne Lo, Fiona Foo, Annika Smith
Background: Psoriasis has been established as an independent risk factor for cardiovascular disease and coronary atherosclerosis. Biologic agents have revolutionised psoriatic skin control and there is emerging evidence that these agents may also address the systemic inflammation of psoriasis. This study aims to assess the change in cardiovascular parameters in a psoriasis cohort after one year of continuous biologic treatment.
Methods: A retrospective review of patients receiving biologic therapy for chronic plaque psoriasis in a single dermatology centre at a major tertiary hospital in Sydney, Australia. The effect of biologic therapy on traditional cardiovascular risk factors was assessed by comparing paired measurement at baseline and 1-year. Factors analysed included including heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and body mass index (BMI).
Results: One hundred and six patients were included in this study. The median age was 44, 63% were male, and the mean BMI on commencement was 30. Ustekinumab, ixekizumab, and secukinumab were most frequently used. No statistically significant change was found amongst the cardiovascular parameters using the full set of patients. Subgroup analysis showed the biologic experienced (BE) group reduced their SBP by 5.7 mmHg and DBP by 3.6 mmHg. Males demonstrated an improvement in SBP and DBP of 5.5 mmHg and 2.2 mmHg respectively. Patients with a BMI ≤25 gained 2.2 kg of weight over a year. There was a strong reduction in psoriasis area and severity index in all groups.
Conclusion: Cardiovascular parameters did not substantially improve after 1 year of biologic therapy despite nearly complete skin clearance. This emphasises the need for greater focus on cardiovascular risk factor control in this cohort and further analysis of the benefits of biologic therapy for the systemic inflammatory sequelae of this disease.