TNF inhibitors best cardiac option for psoriasis patients

Aug 31 2012

By Helen Albert, Senior medwireNews Reporter

Use of tumor necrosis factor (TNF) inhibitors is associated with a significantly reduced risk for myocardial infarction (MI) in psoriasis patients compared with use of other medications, report researchers.

More specifically, the risk for MI was significantly lower in patients treated with TNF inhibitors versus topical agents, and nonsignificantly lower in TNF inhibitor-treated patients versus those given oral agents/phototherapy.

"The effect of systemic treatment for psoriasis on cardiovascular disease has been largely unexplored," write Jashin Wu (Kaiser Permanente Los Angeles Medical Center, Los Angeles, USA) and colleagues in the Archives of Dermatology.

To investigate further, data collected from 8845 patients with at least three International Classification of Diseases codes for psoriasis or psoriatic arthritis who were enrolled in the Kaiser Permanente health plan between 2004 and 2010 were analyzed.

Of these patients, 1673 had received a TNF inhibitor for at least 2 months (median duration 685 days), 2097 received oral agents/phototherapy and did not receive TNF inhibitors, and 5075 used topical agents alone.

Over a median follow-up period of 4.3 years, the incidence of MI in the TNF inhibitor, oral/phototherapy, and topical therapy cohorts was 3.05, 3.85, and 6.73 per 1000 patient-years, respectively.

Following adjustment for MI risk factors, Wu and team calculated that the TNF inhibitor cohort had a significant 50% lower risk for MI than the topical cohort. The risk for MI was also lower in the TNF inhibitor versus the oral agents/phototherapy group, but not statistically significantly.

"Future prospective studies are needed and warranted to determine whether the use of TNF inhibitors may reduce the risk of major adverse cardiovascular events in patients with systemic inflammatory conditions," conclude the authors.

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