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Myocardial infarction risk reduced for psoriasis patients treated with TNFi
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Patients with psoriasis who were assigned tumor necrosis factor-alpha inhibitor therapy had a significant reduction in myocardial infarction incidence compared with patients treated topically, according to retrospective study results.
Researchers evaluated 8,845 patients (mean age, 52.8 years; 50% men) who met at least three international criteria for psoriasis or psoriatic arthritis between January 2004 and November 2010 and had no documented history of myocardial infarction (MI) before the study. Patients were assigned tumor necrosis factor-alpha inhibitors (TNFi) for at least 2 months (n=1,673; 18.9%), oral systemic agents or phototherapy (n=2,097; 23.7%) or a topical therapy (n=5,075; 57.4%).
At 4.3 years median follow-up, there were 221 MI episodes (28, TNFi group; 41, oral/phototherapy; 152, topical) across all groups (overall rate, 5.21 per 1,000 patient-years). With adjustment for MI risk factors, the TNFi group (median therapy duration, 685 days) had a significantly lower hazard ratio for MI compared with the topical cohort (HR=0.50; 95% CI, 0.32-0.79) as did the oral/phototherapy group (HR=0.54; 95% CI, 0.38-0.77). MI incidence in the TNFi, oral/phototherapy and topical groups was 3.05, 3.85 and 6.73 per 1,000 patient-years, respectively, (P<.001).
“The primary objective of this study was to assess whether patients with psoriasis treated with TNF inhibitors have a decreased risk of MI compared with those not treated with TNF inhibitors [ie, those who received oral agents/phototherapy or topical agents],” the researchers said in a news release.
“Future prospective studies are needed and warranted to determine whether the use of TNF inhibitors may reduce the risk of major adverse cardiovascular events in patients with systemic inflammatory conditions,” the researchers concluded.
Disclosure: See the study for a full list of relevant disclosures.
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