Cardiovascular Events in Patients with Psoriasis [Study]

[Fred]

This cohort study looked at cardiovascular events in patients with psoriasis.

Quote:

---

Background:
The cardiovascular safety profile of biologic therapies used for psoriasis is unclear.

Objectives:
To compare the risk of major cardiovascular events (CVEs; acute coronary syndrome, unstable angina, myocardial infarction and stroke) in patients with chronic plaque psoriasis treated with adalimumab, etanercept or ustekinumab in a large prospective cohort.

Methods:
Prospective cohort study examining the comparative risk of major CVEs was conducted using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). The main analysis compared adults with chronic plaque psoriasis receiving ustekinumab with tumour necrosis‐α inhibitors (TNFi: etanercept and adalimumab) while the secondary analyses compared ustekinumab, etanercept, or methotrexate against adalimumab. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using overlap weights by propensity score to balance baseline covariates among comparison groups.

Results:
We included 5,468 biologic‐naïve patients subsequently exposed (951 ustekinumab; 1,313 etanercept; and 3,204 adalimumab) in the main analysis. The secondary analyses also included 2,189 patients receiving methotrexate. The median (p25 – p75) follow up times for patients using ustekinumab, TNFi, adalimumab, etanercept and methotrexate were: 2.01 (1.16 – 3.21), 1.93 (1.05 – 3.34), 1.94 (1.09 – 3.32), 1.92 (0.93 – 3.45) and 1.43 (0.84 – 2.53) years, respectively. Ustekinumab, TNFi, adalimumab, etanercept and methotrexate groups had 7, 29, 23, 6 and 9 patients experiencing major CVEs, respectively. No differences in the risk of major CVEs were observed between biologic therapies (adjusted HR for ustekinumab vs TNFi: 0.96 [95%CI 0.41 – 2.22]; ustekinumab vs adalimumab: 0.81 [0.30 – 2.17]; etanercept vs adalimumab: 0.81 [0.28 – 2.30]) and methotrexate against adalimumab (1.05 [0.34 – 3.28]).

Conclusions:
In this large prospective cohort study, we found no significant differences in the risk of major CVEs between three different biologic therapies and methotrexate. Additional studies, with longer term follow‐up, are needed to investigate the potential effects of biologic therapies on incidence of major CVEs.

Source: onlinelibrary.wiley.com

*Early view funding unknown. 

[Caroline]

So there are no differences found in the studies.
Are there studies comparing
People without Psoriasis
People with Psoriasis and no biologicals
And people with Psoriasis using biologicals?

That would certainly be interesting.
As weight, sometimes even obese, is known with Psoriasis patients, it would be good to compensate those studie for this weight. Using studies that show the relationship between overweight and Psoriasis

[jiml]

I agree with Caroline in that the study is interesting only in as much as it compares the risks of one treatment against another biologicals and methotrexate and found no significant risk  between them
What would be worthwhile is comparing the same drugs  against the general population

[Fred]

Sorry that is all I have, it is an early view.