Apremilast could lower cardiometabolic risk in psoriasis patients
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BOSTON — Psoriasis patients treated with apremilast saw a reduction in subcutaneous and visceral fat, indicating a possible decline in cardiometabolic risk, according to a presentation at the American Academy of Dermatology Annual Meeting.
“We know our patients have an increased risk of obesity, an increased risk of dyslipidemia and an increased risk of diabetes, but on top of that, they have a premature risk of cardiovascular mortality. They die about 5 years younger than they should,” Joel M. Gelfand, MD, MSCE, professor of dermatology and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, said. “So, we have a critical unmet need to understand the impact our treatments have on the cardiometabolic pathways of psoriasis.”
This study included psoriasis patients who received apremilast and completed vascular inflammation, adiposity and blood-based biomarker screenings at baseline, week 16 and week 52.
CT images of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) found a global VAT change of –10.68, or 5.32%, at week 16 and –12.52, or 5.52%, at week 52.
A global change in SAT of –19.86, or 5.53%, was recorded at week 16 and –19.59, or 5.5%, at week 52.
Aortic vascular inflammation was neutral throughout the study with a reduction of –0.02 at week 16 and –0.07 at week 52.
“Our finding that psoriasis patients treated with apremilast experience a 5% reduction in visceral fat at week 16 and that this reduction persists for 52 weeks is quite provocative,” Gelfand told Healio. “Visceral fat is metabolically active and is associated with an increased risk of diabetes and cardiovascular disease. It’s possible that these reductions in visceral fat may result in a future reduction in cardiometabolic risk.”
Further randomized controlled trials are needed to confirm this hypothesis, Gelfand suggested.
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Gelfand J, et al. A phase IV, open label study of the effects of apremilast on vascular inflammation and cardiometabolic function in psoriasis (The VIP-A trial). Presented at: American Academy of Dermatology Annual Meeting; March 25-29, 2022; Boston.
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