Methotrexate and cardiovascular in psoriasis patients

[Fred]

This study was conducted to evaluate the impact of methotrexate on cardiovascular outcomes in patients with psoriasis.

Quote:

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Background:
Psoriasis is a chronic immune-mediated inflammatory disease with a global prevalence of 2%–3% and 1.3% in Brazil. It is associated with comorbidities such as obesity, hypertension, and diabetes, all of which contribute to increased cardiovascular risk due to systemic inflammation and endothelial dysfunction. Methotrexate (MTX), a commonly used treatment for psoriasis, may influence cardiovascular outcomes through its anti-inflammatory effects.

Objectives:
To evaluate the impact of methotrexate on cardiovascular outcomes in patients with psoriasis, particularly its potential to reduce cardiovascular risk by controlling systemic inflammation.

Methods:
A systematic review was conducted according to PRISMA guidelines. Searches were performed in pub med, Cochrane, Embase, and Web of Science databases. Eligible studies assessed the effects of methotrexate on cardiovascular outcomes in psoriasis patients. Case reports and narrative reviews were excluded. Study quality was assessed using the RoB-2 and GRADE tools. From 143 initially identified records, four studies met the inclusion criteria. Meta-analyses using fixed-effects and random-effects models were conducted to estimate pooled odds ratios (ORs).

Results:
Under the fixed-effects model, methotrexate was associated with a significant reduction in cardiovascular risk (OR = 0.62; 95% CI: 0.57–0.68). However, due to high heterogeneity, the random-effects model yielded nonsignificant results (OR = 0.86; 95% CI: 0.54–1.35). The incidence of cardiovascular events was similar between the methotrexate (3.6%) and control (3.7%) groups.

Conclusions:
Methotrexate shows promise in reducing cardiovascular risk in psoriasis patients, likely due to its anti-inflammatory properties. It appears to be a safer option compared to agents such as retinoids. Nonetheless, the high heterogeneity and methodological limitations of available studies hinder definitive conclusions. Further research should prioritize standardized outcome measures, comparisons with biologics, and individualized therapeutic approaches.

Source: onlinelibrary.wiley.com

*Funding: The authors received no specific funding for this work

[Caroline]

I am very much interested in the “other” options, the biologics and individualise approaches even lifestyle.

What is not shown in this study is the damage that is done to other organs.

And… it seems logical to me that reduced inflammation is better for everything… that conclusion is the most important, that the inflammation should be fought with psoriasis and Psoriatic Arthritis

[Fred]

@Caroline I think you know my thoughts about methotrexate, much the same as yours. ........................ It's poison and should not be used for people with psoriasis and you are right, no mention of the damage it can do not only organs but also mental health.

Time to move well away from this cheap treatment that gives more problems to people with psoriasis than it does help, it will only make things worse in the end and the patient will have to move on.

*Anyone getting told to use methotrexate, tell them you like some alcohol or want to start a family and watch their reaction.

It''s poison and it's your body they are playing with.

This post is personal and not one as the owner of Psoriasis Club, I'm just here to give you the news whilst still having a patients opinion.

You decide for yourself or better still register with Psoriasis Club and talk to others and ask others their opinions of any treatments, we are real people and our members are honest in their thoughts.

[mataribot]

Why do I always think of a zombie apocalypse when I think of MTX?

[Fred]

Why do I always think of a zombie apocalypse when I think of MTX?

That sums it up well.     

[Caroline]

Why do I always think of a zombie apocalypse when I think of MTX?

That sums it up well.