VIP-U: Psoriasis treatment reduces vascular inflammation

Vascular inflammation was reduced in patients who were treated for psoriasis with ustekinumab, according to results from the VIP-U study presented at the American Academy of Dermatology Annual Meeting.

“What’s important at this stage is the concept and the promise,” Joel M. Gelfand, MD, MSCE, director of the Psoriasis and Phototherapy Treatment Center, vice chair of clinical research, medical director of the dermatology clinical studies unit, professor of dermatology and professor of epidemiology in biostatistics and epidemiology at the University of Pennsylvania, told Cardiology Today. “We know inflammation is an important risk factor for CVD. Just recently, the CANTOS trial proved that blocking inflammation with an antibody against interleukin-1b lowers the risk of major cardiovascular events. Our study demonstrates that blocking interleukin-12/23 not only improves inflammation in the skin, joints and bowels, but also in the aorta, proving that it is capable of biologically hitting the target.”

Researchers analyzed data from 43 patients (mean age, 42 years) who had a psoriasis area severity index greater than 12 and a body surface area of at least 10. At baseline, patients were washed out of their psoriasis treatment.

Patients were assigned to ustekinumab (Stelara, Janssen) or placebo for 12 weeks. The primary outcome of interest was aortic inflammation, which was measured by fluorine-18 fluorodeoxyglucose PET/CT scans at baseline and 12 weeks.

At 12 weeks, 41 patients completed the trial.

Seventy-seven percent of patients assigned ustekinumab achieved a 75% reduction in psoriasis area severity index compared with 11% of patients in the placebo group (P < .001).

At the end of the study, total aortic vascular inflammation was reduced by 6.6% in patients assigned ustekinumab and increased by 12.1% in patients assigned placebo (P = .001).

“There is a need for treatments that can lower CV risk by modulating inflammation while not significantly increasing the risk of side effects such as infection,” Gelfand told Cardiology Today. “The emerging biologics in psoriasis have an impressive safety profile and may ultimately prove to offer benefits beyond the skin, extending to cardiovascular disease prevention.” – by Darlene Dobkowski

Reference:

Gelfand JM, et al. Abstract 6645. Presented at: American Academy of Dermatology Annual Meeting; Feb. 16-20, 2018; San Diego.

Disclosures: The study was funded by Janssen Scientific Affairs. Gelfand reports he is a consultant for Bristol-Myers Squibb, Coherus, Dermira, Dr. Reddy’s Labs, GlaxoSmithKline, Janssen Biologics, Menlo Therapeutics, Novartis, Pfizer, Regeneron and Sanofi; receives honoraria and research grants from AbbVie, Celgene, Janssen, Novartis, Pfizer, Regeneron and Sanofi; and has received payment for CME work related to psoriasis that was supported by AbbVie, Lilly and Valeant.