No cardiovascular risk differences found between biologic treatments for psoriatic disease
Key takeaways:
- There was no significant difference in cardiovascular risks among patients treated with biologics for psoriatic disease.
- These findings were consistent across psoriatic disease subtypes.
A study found patients treated with interleukin inhibitors did not experience a difference in the rates of major adverse cardiovascular and venous thromboembolic events compared with those treated with tumor necrosis factor inhibitors.
“Numerous biologic agents ... are currently available and licensed for treating psoriasis and PsA,” Tai-Li Chen, MD, of the department of dermatology at Taipei Veterans General Hospital in Taiwan, and colleagues wrote. “As chronic systemic inflammation in psoriatic disease may contribute to the development of atherosclerosis and thrombosis, biologics possessing anti-inflammatory effects can theoretically improve atherosclerosis and can thus modulate the risk of cardiovascular disease.”
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The emulated target study investigated the differences in the risks for major adverse cardiovascular events (MACE) and venous thromboembolic events (VTE) among biologic-naïve patients treated with IL inhibitors vs. tumor necrosis factor inhibitors (TNFi).
The study grouped 32,098 patients with psoriasis or psoriatic arthritis (PsA) into their respective categories based on biologic treatment, which included TNFi (n = 20,314), IL-17i (n = 5,073), IL-12/23i (n = 3,573) and IL-23i (n = 3,138).
Results showed that there was no significant difference in the risks for MACE and VTE among the biologic groups across psoriatic disease.
The rates of MACE between adults with psoriatic disease receiving IL-17i vs. those receiving TNFi were 111 vs. 97 (IRR [incidence rate ratio] = 1.14; 95% CI, 0.86-1.52). The rate of events among those receiving IL-12/23i vs. TNFi were 68 vs. 55 (IRR = 1.24; 95% CI, 0.84-1.78) and the rates among the IL-23i group vs. the TNFi group were 50 vs. 54 (IRR = 0.93; 95% CI, 0.61-1.38).
Among patients with psoriatic disease, the rates of VTEs were even lower than MACEs, with those receiving IL-12/23i vs. TNFi experiencing 21 vs. 14 events (IRR = 1.51; 95% CI, 0.73-3.19), those receiving IL-23i vs. TNFi experiencing 17 vs. 12 events (IRR = 1.42; 95% CI, 0.64-3.25) and those receiving IL-17i vs. TNFi experiencing 28 vs. 25 events (IRR = 1.12; 95% CI, 0.63-2.08).
These findings were consistent across psoriatic disease subtypes with no significant difference being detected between patients with psoriasis vs. PsA.
However, the authors did find that patients with pre-existing hyperlipidemia and diabetes mellitus did see lower MACE and VTE rates when treated with new biologics vs. TNFi.
“In conclusion, no significant MACE and VTE risk differences were detected in patients with psoriasis or PsA between those receiving IL-17i, IL-12/23i and IL-23i and those with TNFi,” the authors wrote. “These findings can be considered by physicians and patients when making treatment decisions.”