Health Boards
Objective:
To assess whether patients with psoriasis treated with tumor necrosis factor (TNF) inhibitors have a decreased risk of *myocardial infarction (MI) compared with those not treated with TNF inhibitors.
Design:
Retrospective cohort study.
Setting:
Kaiser Permanente Southern California health plan.
Patients:
Patients with at least 3 International Classification of Diseases, Ninth Revision, Clinical Modification, codes for psoriasis (696.1) or psoriatic arthritis (696.0) (without antecedent MI) between January 1, 2004, and November 30, 2010.
Main Outcome Measure:
Incident MI.
Results:
Of 8845 patients included: 1673 received a TNF inhibitor for at least 2 months (TNF inhibitor cohort), 2097 were TNF inhibitor naive and received other systemic agents or phototherapy (oral/phototherapy cohort), and 5075 were not treated with TNF inhibitors, other systemic therapies, or phototherapy (topical cohort). The median duration of follow-up was 4.3 years (interquartile range, 2.9-5.5 years), and the median duration of TNF inhibitor therapy was 685 days (interquartile range, 215-1312 days). After adjusting for MI risk factors, the TNF inhibitor cohort had a significantly lower hazard of MI compared with the topical cohort (adjusted hazard ratio, 0.50; 95% CI, 0.32-0.79). The incidence of MI in the TNF inhibitor, oral/phototherapy, and topical cohorts were 3.05, 3.85, and 6.73 per 1000 patient-years, respectively.
Conclusions:
Use of TNF inhibitors for psoriasis was associated with a significant reduction in MI risk and incident rate compared with treatment with topical agents. Use of TNF inhibitors for psoriasis was associated with a non–statistically significant lower MI incident rate compared with treatment with oral agents/phototherapy.
Source: archderm.jamanetwork.com
*Myocardial Infarction (MI) is commonly known as a heart attack.
To assess whether patients with psoriasis treated with tumor necrosis factor (TNF) inhibitors have a decreased risk of *myocardial infarction (MI) compared with those not treated with TNF inhibitors.
Design:
Retrospective cohort study.
Setting:
Kaiser Permanente Southern California health plan.
Patients:
Patients with at least 3 International Classification of Diseases, Ninth Revision, Clinical Modification, codes for psoriasis (696.1) or psoriatic arthritis (696.0) (without antecedent MI) between January 1, 2004, and November 30, 2010.
Main Outcome Measure:
Incident MI.
Results:
Of 8845 patients included: 1673 received a TNF inhibitor for at least 2 months (TNF inhibitor cohort), 2097 were TNF inhibitor naive and received other systemic agents or phototherapy (oral/phototherapy cohort), and 5075 were not treated with TNF inhibitors, other systemic therapies, or phototherapy (topical cohort). The median duration of follow-up was 4.3 years (interquartile range, 2.9-5.5 years), and the median duration of TNF inhibitor therapy was 685 days (interquartile range, 215-1312 days). After adjusting for MI risk factors, the TNF inhibitor cohort had a significantly lower hazard of MI compared with the topical cohort (adjusted hazard ratio, 0.50; 95% CI, 0.32-0.79). The incidence of MI in the TNF inhibitor, oral/phototherapy, and topical cohorts were 3.05, 3.85, and 6.73 per 1000 patient-years, respectively.
Conclusions:
Use of TNF inhibitors for psoriasis was associated with a significant reduction in MI risk and incident rate compared with treatment with topical agents. Use of TNF inhibitors for psoriasis was associated with a non–statistically significant lower MI incident rate compared with treatment with oral agents/phototherapy.
Source: archderm.jamanetwork.com
*Myocardial Infarction (MI) is commonly known as a heart attack.