Humira v Fumaric Acid Esters on cardiovascular disease in psoriasis

[Fred]

This study compared Humira (adalimumab) and Fumaric Acid Esters (FAE) on cardiovascular disease markers in psoriasis patients.

Quote:

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Background:
The effect of adalimumab and fumaric acid esters (FAE) on the cardiovascular risk associated with psoriasis has only been investigated scarcely in randomized controlled studies.

Objective:
The aim of this prospective, randomized controlled head‐to‐head trial was to compare the influence of adalimumab and FAE on cardiovascular disease markers in psoriasis patients.

Methods:
65 patients with moderate to severe plaque psoriasis were randomly assigned to adalimumab or FAE treatment for 6 months. Cardiovascular hemodynamic parameters (flow mediated dilation (FMD), nitro‐glycerine mediated dilation (NMD) and carotid intima media thickness (CIMT), blood pressure) were assessed at baseline(v0) and after 6 months(v6). Cutaneous disease severity, inflammatory and lipid cardiovascular risk markers were analysed at baseline(v0), after three(v3) and six months(v6).

Results:
After 6 months of treatment FMD in the adalimumab group increased significantly (v0 5,9% (6,4% S.D), v6 8,0% (4,8% S.D.), p=0,048) but not in the FAE group. (v0 7,0% (4,1% S.D), v6 8,4% (6,1% S.D.), p=0,753) This was paralleled by a significant decrease of hsCRP in the adalimumab group in comparison to the FAE group (v0: 0,39 mg/dl (0,38 S.D.), v6: 0,39mg/dl (0,48 S.D.), p=0,043). No significant changes were observed in any other hemodynamic parameters. FAE, however, additionally decreased total cholesterol (p=0,046) and apolipoprotein B (p=0,041) levels compared to adalimumab. Mean PASI (psoriasis area severity score) reduction was greater but not significant (p=0,116) under adalimumab treatment compared to FAE treatment ( ‐71,1% (29,9 S.D) vs. ‐54,6% (45,7%)).

Conclusion:
In our study both treatments were documented to exert effects on the cardiovascular system. While adalimumab showed anti‐inflammatory effects and improved FMD, FAE interacted favourably with the cholesterol metabolism.

Source: onlinelibrary.wiley.com

*Early view funding unknown

Humira (adalimumab)

Dimethylfumarates and Psoriasis

[Caroline]

Very interesting.

[jiml]

Very interesting.

Yes very interesting I wonder why they compared FAE to Humira instead of any other biological

And I also wonder what it actually means, are they thinking that using either increases the risk of cardiovascular disease compared with no treatment

[Caroline]

Very interesting.

Yes very interesting I wonder why they compared FAE to Humira instead of any other biological

And I also wonder what it actually means, are they thinking that using either increases the risk of cardiovascular disease compared with no treatment

No ...the other way around Jim.
They think that the medication you get is reducing the risk on cardiovascular disease. At least that is logical.
Psoriasis is a situation of the immune system that is working too hard. This causes a certain risk as there is a continuous inflammation stimulation which is not good.
By using a bio or FAE/DMF this inflammation is being reduced and thus may have a positive effect on your health overall.

Covid-19 is in fact also a derailment of the immune system, it may in fact be an induced auto immune reaction of several parts of your body. This would mean that it is logical that one or more specific bio’s and perhaps also FAE, has an inflammation reducing effect when one has been contaminated with Covid-19.

All strictly logical thinking, without detailed medical knowledge which I lack.

[jiml]

Thanks Caroline for the explanation
I'll let you know if I get Covid -19 and if the dmf offered any protection

[mataribot]

Some drugs slow down disease progression, while others simply cover it up. I think that’s the point of the study. But it doesn’t go far enough.