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Patients with psoriasis treated with TNF inhibitors vs. methotrexate experienced lower CV risk

Patients with psoriasis who were treated with tumor necrosis factor-alpha inhibitors had a lower risk for major cardiovascular events compared with patients treated with methotrexate, according to study results recently published in the Journal of the American Academy of Dermatology.

Researchers used the Truven Market Scan Databases between 2000 and 2011 to identify 58,239 patients with psoriasis who had at least two tumor necrosis factor-alpha inhibitor (TNFi) or methotrexate (MTX) prescriptions.  The TNFi initiation date or randomly selected MTX dispensing date was determined by the index date for each of the drugs.

There were 9,148 patients (mean age, 46.3 years; 44.5% female) treated with TNFi and 8,581 patients (mean age, 52.4 years; 53.1% female) in the MTX cohort included in the study.

Diagnoses of myocardial infarction, stroke or transient ischemic attack or unstable angina recorded during a claim of an inpatient stay were used to define major cardiovascular (CV) events.

The patients in the TNFi cohort had fewer cardiovascular events at 12 months compared with the MTX cohort (Kaplan-Meier rates, 1.45% vs. 4.09%; P <. 001).

Overall lower CV event hazards were reported for the TNFi users compared with the MTX cohort (HR = 0.55; 95% CI, 0.45-0.67). Each additional 6 months of TNFi cumulative exposure was associated with an 11% reduction in the risk for major CV events, according to regression analyses during a median follow-up of 24 months (P =.02).

“A cumulative exposure to TNFi agents was found to be associated with reduced hazards for CV events,” the researchers concluded.  – by Bruce Thiel

Disclosure: Wu reports receiving research funding from AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Coherus BioSciences, Dermira, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Regeneron, Sandoz and Sun Pharmaceutical Industries and being a consultant for AbbVie, Amgen, Celgene, Dermira, Eli Lilly, Pfizer, Regeneron and Sun Pharmaceutical Industries.

Please see the study for other researchers’ relevant financial disclosures.