Investigating the Link between Psoriasis and Cardiovascular Disease: Current Evidence, Therapeutic Implications and Perspectives

Author(s): Eirini Kapniari*, Prokopios Papadimitriou, Marianna Dalamaga, George Makavos, Stefano Piaserico, Alexander Egeberg, Ignatios Ikonomidis, Evangelia Papadavid

Journal Name: Current Vascular Pharmacology

Volume 18 , Issue 6 , 2020

Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Psoriasis; a chronic inflammatory disease is characterized by symmetric hyperkeratotic plaques affecting any part of the body. Psoriasis is nowadays considered as a systemic inflammation linked with several comorbidities as metabolic syndrome, depression, anxiety and increased prevalence of cardiovascular (CV) disease. The hypothesis that psoriasis is an independent CV risk factor leading to atherosclerosis via inflammation is now widely accepted. Deciphering the underlying mechanisms interconnecting psoriasis and CV disease may have significant implications in treatment decisions. Accumulating evidence suggests that systematic therapies and recently introduced biologic agents, that control psoriasis by suppressing the chronic and systemic inflammation, may alter the progression of CV disease. We herein attempt a review of current evidence analysing the relationship between psoriasis and CV comorbidities, comment on the mechanisms underlying this association and investigate the consequences for the management of psoriasis.

Keywords: Psoriasis, cardiovascular diseases, inflammation, anti-inflammatory agents, biologics, skin disease.

Gudjonsson JE, Elder JT. Psoriasis: epidemiology. Clin Dermatol 2007; 25(6): 535-46.
[] [PMID: 18021890]
Henseler T, Christophers E. Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris. J Am Acad Dermatol 1985; 13(3): 450-6.
[] [PMID: 4056119]
Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet 2007; 370(9583): 263-71.
[] [PMID: 17658397]
Gelfand JM, Feldman SR, Stern RS, Thomas J, Rolstad T, Margolis DJ. Determinants of quality of life in patients with psoriasis: a study from the US population. J Am Acad Dermatol 2004; 51(5): 704-8.
[] [PMID: 15523347]
Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 national psoriasis foundation patient-membership survey. Arch Dermatol 2001; 137(3): 280-4.
[PMID: 11255325]
Sherer Y, Shoenfeld Y. Mechanisms of disease: atherosclerosis in autoimmune diseases. Nat Clin Pract Rheumatol 2006; 2(2): 99-106.
[] [PMID: 16932663]
Abou-Raya S, Abou-Raya A, Naim A, Abuelkheir H. Chronic inflammatory autoimmune disorders and atherosclerosis. Ann N Y Acad Sci 2007; 1107: 56-67.
[] [PMID: 17804533]
Anaya JM. Common mechanisms of autoimmune diseases (the autoimmune tautology). Autoimmun Rev 2012; 11(11): 781-4.
[] [PMID: 22353402]
McDonald CJ, Calabresi P. Complication of psoriasis. JAMA 1973; 224(5): 629.
[] [PMID: 4739794]
McDonald CJ, Calabresi P. Occlusive vascular disease in psoriatic patients. N Engl J Med 1973; 288(17): 912.
[] [PMID: 4692910]
Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA 2006; 296(14): 1735-41.
[] [PMID: 17032986]
Kimball AB, Robinson D Jr, Wu Y, et al. Cardiovascular disease and risk factors among psoriasis patients in two US healthcare databases, 2001-2002. Dermatology (Basel) 2008; 217(1): 27-37.
[] [PMID: 18349542]
Ahlehoff O, Gislason GH, Charlot M, et al. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. J Intern Med 2011; 270(2): 147-57.
[] [PMID: 21114692]
Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies. J Am Heart Assoc 2013; 2(2): e000062.
[] [PMID: 23557749]
Horreau C, Pouplard C, Brenaut E, et al. Cardiovascular morbidity and mortality in psoriasis and psoriatic arthritis: a systematic literature review. J Eur Acad Dermatol Venereol 2013; 27(Suppl. 3): 12-29.
[] [PMID: 23845149]
Samarasekera EJ, Neilson JM, Warren RB, Parnham J, Smith CH. Incidence of cardiovascular disease in individuals with psoriasis: A systematic review and meta-analysis. J Invest Dermatol 2013; 133(10): 2340-6.
[] [PMID: 23528816]
Dowlatshahi EA, Kavousi M, Nijsten T, et al. Psoriasis is not associated with atherosclerosis and incident cardiovascular events: the Rotterdam Study. J Invest Dermatol 2013; 133(10): 2347-54.
[] [PMID: 23492918]
Wakkee M, Herings RM, Nijsten T. Psoriasis may not be an independent risk factor for acute ischemic heart disease hospitalizations: results of a large population-based Dutch cohort. J Invest Dermatol 2010; 130(4): 962-7.
[] [PMID: 19812600]
Stern RS. Psoriasis is not a useful independent risk factor for cardiovascular disease. J Invest Dermatol 2010; 130(4): 917-9.
[] [PMID: 20231828]
Parisi R, Rutter MK, Lunt M, et al. Identification and management of psoriasis associated comorbidity (IMPACT) project team. Psoriasis and the risk of major cardiovascular events: cohort study using the clinical practice research datalink. J Invest Dermatol 2015; 135(9): 2189-97.
[] [PMID: 25742120]
Gaeta M, Castelvecchio S, Ricci C, Pigatto P, Pellissero G, Cappato R. Role of psoriasis as independent predictor of cardiovascular disease: a meta-regression analysis. Int J Cardiol 2013; 168(3): 2282-8.
[] [PMID: 23490084]
Raaby L, Ahlehoff O, de Thurah A. Psoriasis and cardiovascular events: updating the evidence. Arch Dermatol Res 2017; 309(3): 225-8.
[] [PMID: 28213804]
Alinaghi F, Calov M, Kristensen LE, et al. Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies. J Am Acad Dermatol 2019; 80(1): 251-65.
[] [PMID: 29928910]
Papadavid E, Katsimbri P, Kapniari I, et al. Prevalence of psoriatic arthritis and its correlates among patients with psoriasis in Greece: results from a large retrospective study. J Eur Acad Dermatol Venereol 2016; 30(10): 1749-52.
[] [PMID: 27508394]
Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med 2017; 376(10): 957-70.
[] [PMID: 28273019]
Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005; 64(Suppl. 2): 14-7.
[] [PMID: 15708927]
Husted JA, Thavaneswaran A, Chandran V, et al. Cardiovascular and other comorbidities in patients with psoriatic arthritis: a comparison with patients with psoriasis. Arthritis Care Res (Hoboken) 2011; 63(12): 1729-35.
[] [PMID: 21905258]
Peluso R, Caso F, Tasso M, et al. Biomarkers of subclinical atherosclerosis in patients with psoriatic arthritis. Open Access Rheumatol 2019; 11: 143-56.
[] [PMID: 31388317]
Sobchak C, Eder L. Cardiometabolic disorders in psoriatic disease. Curr Rheumatol Rep 2017; 19(10): 63.
[] [PMID: 28844116]
Eder L, Jayakar J, Shanmugarajah S, et al. The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. Ann Rheum Dis 2013; 72(5): 715-20.
[] [PMID: 22736087]
Jamnitski A, Symmons D, Peters MJ, Sattar N, McInnes I, Nurmohamed MT. Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis 2013; 72(2): 211-6.
[] [PMID: 22532629]
Ogdie A, Yu Y, Haynes K, et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis 2015; 74(2): 326-32.
[] [PMID: 25351522]
Polachek A, Touma Z, Anderson M, Eder L. Risk of cardiovascular morbidity in patients with psoriatic arthritis: A meta-analysis of observational studies. Arthritis Care Res (Hoboken) 2017; 69(1): 67-74.
[] [PMID: 27111228]
Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatol 2013; 149(1): 84-91.
[] [PMID: 23407990]
Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens 2013; 31(3): 433-42.
[] [PMID: 23249828]
Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes 2012; 2: e54.
[] [PMID: 23208415]
Ma C, Harskamp CT, Armstrong EJ, Armstrong AW. The association between psoriasis and dyslipidaemia: a systematic review. Br J Dermatol 2013; 168(3): 486-95.
[] [PMID: 23106411]
Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies. J Am Acad Dermatol 2013; 68(4): 654-62.
[] [PMID: 23360868]
Takeshita J, Grewal S, Langan SM, et al. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol 2017; 76(3): 377-90.
[] [PMID: 28212759]
Fernández-Armenteros JM, Gómez-Arbonés X, Buti-Soler M, et al. Psoriasis, metabolic syndrome and cardiovascular risk factors. A population-based study. J Eur Acad Dermatol Venereol 2019; 33(1): 128-35.
[] [PMID: 29953676]
Chan WMM, Yew YW, Theng TSC, et al. Prevalence of metabolic syndrome in patients with psoriasis: a cross-sectional study in Singapore. Singapore Med J 2020; 61(4): 194-99.
[] [PMID: 31788703]
Jung KJ, Kim TG, Lee JW, et al. Increased risk of atherosclerotic cardiovascular disease among patients with psoriasis in Korea: A 15-year nationwide population-based cohort study. J Dermatol 2019; 46(10): 859-66.
[] [PMID: 31432567]
D’Agostino RB Sr, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008; 117(6): 743-53.
[] [PMID: 18212285]
Lee EJ, Han KD, Han JH, Lee JH. Smoking and risk of psoriasis: A nationwide cohort study. J Am Acad Dermatol 2017; 77(3): 573-5.
[] [PMID: 28807112]
Danielsen K, Wilsgaard T, Olsen AO, Furberg AS. Overweight and weight gain predict psoriasis development in a population-based cohort. Acta Derm Venereol 2017; 97(3): 332-9.
[] [PMID: 27602427]
Sondermann W, Djeudeu Deudjui DA, Korber A, et al. Psoriasis, cardiovascular risk factors and metabolic disorders: sex-specific findings of a population-based study. J Eur Acad Dermatol Venereol 2020; 34(4): 779-86.
[]] [PMID: 31797464]
Egeberg A, Griffiths CEM, Williams HC, et al. Clinical characteristics, symptoms and burden of psoriasis and atopic dermatitis in adults. Br J Dermatol 2019; 183(1): 128-38.
Egeberg A, Bruun LE, Mallbris L, et al. Family history predicts major adverse cardiovascular events (MACE) in young adults with psoriasis. J Am Acad Dermatol 2016; 75(2): 340-6.
[] [PMID: 27283226]
Nograles KE, Davidovici B, Krueger JG. New insights in the immunologic basis of psoriasis. Semin Cutan Med Surg 2010; 29(1): 3-9.
[] [PMID: 20430301]
Späh F. Inflammation in atherosclerosis and psoriasis: common pathogenic mechanisms and the potential for an integrated treatment approach. Br J Dermatol 2008; 159(Suppl. 2): 10-7.
[] [PMID: 18700910]
Ryan C, Kirby B. Psoriasis is a systemic disease with multiple cardiovascular and metabolic comorbidities. Dermatol Clin 2015; 33(1): 41-55.
[] [PMID: 25412782]
Ross R. Atherosclerosis is an inflammatory disease. Am Heart J 1999; 138(5 Pt 2): S419-20.
[] [PMID: 10539839]
Libby P. Inflammation in atherosclerosis. Nature 2002; 420(6917): 868-74.
[] [PMID: 12490960]
Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005; 352(16): 1685-95.
[] [PMID: 15843671]
Ol KK, Agachan B, Gormus U, Toptas B, Isbir T. Cox-2 gene polymorphism and IL-6 levels in coronary artery disease. Genet Mol Res 2011; 10(2): 810-6.
[] [PMID: 21574137]
Kleinbongard P, Heusch G, Schulz R. TNFalpha in atherosclerosis, myocardial ischemia/reperfusion and heart failure. Pharmacol Ther 2010; 127(3): 295-314.
[] [PMID: 20621692]
Erbel C, Dengler TJ, Wangler S, et al. Expression of IL-17A in human atherosclerotic lesions is associated with increased inflammation and plaque vulnerability. Basic Res Cardiol 2011; 106(1): 125-34.
[] [PMID: 21116822]
Alexandroff AB, Pauriah M, Camp RD, Lang CC, Struthers AD, Armstrong DJ. More than skin deep: atherosclerosis as a systemic manifestation of psoriasis. Br J Dermatol 2009; 161(1): 1-7.
[] [PMID: 19500102]
Cheng X, Yu X, Ding YJ, et al. The Th17/Treg imbalance in patients with acute coronary syndrome. Clin Immunol 2008; 127(1): 89-97.
[] [PMID: 18294918]
Boehncke WH, Boehncke S, Tobin AM, Kirby B. The ‘psoriatic march’: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol 2011; 20(4): 303-7.
[] [PMID: 21410760]
Boehncke WH. Systemic inflammation and cardiovascular comorbidity in psoriasis patients: causes and consequences. Front Immunol 2018; 9: 579.
[] [PMID: 29675020]
Flammer AJ, Ruschitzka F. Psoriasis and atherosclerosis: two plaques, one syndrome? Eur Heart J 2012; 33(16): 1989-91.
[] [PMID: 22108835]
Davidovici BB, Sattar N, Prinz J, et al. Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol 2010; 130(7): 1785-96.
[] [PMID: 20445552]
Ghazizadeh R, Shimizu H, Tosa M, Ghazizadeh M. Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci 2010; 7(5): 284-9.
[] [PMID: 20827428]
Mehta NN, Li K, Szapary P, Krueger J, Brodmerkel C. Modulation of cardiometabolic pathways in skin and serum from patients with psoriasis. J Transl Med 2013; 11: 194.
[] [PMID: 23965158]
Boehncke S, Thaci D, Beschmann H, et al. Psoriasis patients show signs of insulin resistance. Br J Dermatol 2007; 157(6): 1249-51.
[] [PMID: 17916217]
Ucak S, Ekmekci TR, Basat O, Koslu A, Altuntas Y. Comparison of various insulin sensitivity indices in psoriatic patients and their relationship with type of psoriasis. J Eur Acad Dermatol Venereol 2006; 20(5): 517-22.
[] [PMID: 16684277]
Lago R, Gómez R, Lago F, Gómez-Reino J, Gualillo O. Leptin beyond body weight regulation--current concepts concerning its role in immune function and inflammation. Cell Immunol 2008; 252(1-2): 139-45.
[] [PMID: 18289518]
Kitas GD, Gabriel SE. Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 2011; 70(1): 8-14.
[] [PMID: 21109513]
Kolliker Frers RA, Cosentino V, Tau J, et al. Immune-mediated inflammation promotes subclinical atherosclerosis in recent-onset psoriatic arthritis patients without conventional cardiovascular risk factors. Front Immunol 2018; 9: 139.
[] [PMID: 29535705]
Balci DD, Balci A, Karazincir S, et al. Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis. J Eur Acad Dermatol Venereol 2009; 23(1): 1-6.
[] [PMID: 18702627]
Gisondi P, Fantin F, Del Giglio M, et al. Chronic plaque psoriasis is associated with increased arterial stiffness. Dermatology (Basel) 2009; 218(2): 110-3.
[] [PMID: 19060461]
Bicer A, Acikel S, Kilic H, et al. Impaired aortic elasticity in patients with psoriasis. Acta Cardiol 2009; 64(5): 597-602.
[] [PMID: 20058504]
Shaharyar S, Warraich H, McEvoy JW, et al. Subclinical cardiovascular disease in plaque psoriasis: association or causal link? Atherosclerosis 2014; 232(1): 72-8.
[] [PMID: 24401219]
Fang N, Jiang M, Fan Y. association between psoriasis and subclinical atherosclerosis: a meta-analysis. Medicine (Baltimore) 2016; 95(20): e3576.
[] [PMID: 27196459]
Ludwig RJ, Herzog C, Rostock A, et al. Psoriasis: a possible risk factor for development of coronary artery calcification. Br J Dermatol 2007; 156(2): 271-6.
[] [PMID: 17223866]
Santilli S, Kast DR, Grozdev I, et al. Visualization of atherosclerosis as detected by coronary artery calcium and carotid intima-media thickness reveals significant atherosclerosis in a cross-sectional study of psoriasis patients in a tertiary care center. J Transl Med 2016; 14(1): 217.
[] [PMID: 27448600]
Ikonomidis I, Makavos G, Papadavid E, et al. Similarities in coronary function and myocardial deformation between psoriasis and coronary artery disease: the role of oxidative stress and inflammation. Can J Cardiol 2015; 31(3): 287-95.
[] [PMID: 25660150]
Mehta NN, Yu Y, Saboury B, et al. Systemic and vascular inflammation in patients with moderate to severe psoriasis as measured by [18F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT): a pilot study. Arch Dermatol 2011; 147(9): 1031-9.
[] [PMID: 21576552]
Naik HB, Natarajan B, Stansky E, et al. Severity of psoriasis associates with aortic vascular inflammation detected by FDG PET/CT and neutrophil activation in a prospective observational study. Arterioscler Thromb Vasc Biol 2015; 35(12): 2667-76.
[] [PMID: 26449753]
Pirro M, Stingeni L, Vaudo G, et al. Systemic inflammation and imbalance between endothelial injury and repair in patients with psoriasis are associated with preclinical atherosclerosis. Eur J Prev Cardiol 2015; 22(8): 1027-35.
[] [PMID: 24906366]
Egeberg A, Skov L, Joshi AA, et al. The relationship between duration of psoriasis, vascular inflammation, and cardiovascular events. J Am Acad Dermatol 2017; 77(4): 650-56.
[] [PMID: 28826925]
Manolis AA, Manolis TA, Melita H, Manolis AS. Psoriasis and cardiovascular disease: the elusive link. Int Rev Immunol 2019; 38(1): 33-54.
[] [PMID: 30457023]
Dattilo G, Borgia F, Guarneri C, et al. Cardiovascular risk in psoriasis: current state of the art. Curr Vasc Pharmacol 2019; 17(1): 85-91.
[] [PMID: 29149819]
Ridker PM, Everett BM, Thuren T, et al. Anti-inflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017; 377(12): 1119-31.
[] [PMID: 28845751]
Prodanovich S, Ma F, Taylor JR, Pezon C, Fasihi T, Kirsner RS. Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol 2005; 52(2): 262-7.
[] [PMID: 15692471]
Micha R, Imamura F, Wyler von Ballmoos M, et al. Systematic review and meta-analysis of methotrexate use and risk of cardiovascular disease. Am J Cardiol 2011; 108(9): 1362-70.
[] [PMID: 21855836]
Ahlehoff O, Skov L, Gislason G, et al. Cardiovascular outcomes and systemic anti-inflammatory drugs in patients with severe psoriasis: 5-year follow-up of a Danish nationwide cohort. J Eur Acad Dermatol Venereol 2015; 29(6): 1128-34.
[] [PMID: 25303139]
Cesari M, Penninx BW, Newman AB, et al. Inflammatory markers and cardiovascular disease (the health, aging and body composition [Health ABC] study). Am J Cardiol 2003; 92(5): 522-8.
[] [PMID: 12943870]
Caldarola G, De Simone C, Carbone A, Tulli A, Amerio P, Feliciani C. TNFalpha and its receptors in psoriatic skin, before and after treatment with etanercept. Int J Immunopathol Pharmacol 2009; 22(4): 961-6.
[] [PMID: 20074459]
Langley RG, Strober BE, Gu Y, Rozzo SJ, Okun MM. Benefit-risk assessment of tumour necrosis factor antagonists in the treatment of psoriasis. Br J Dermatol 2010; 162(6): 1349-58.
[] [PMID: 20394634]
Kircik LH, Del Rosso JQ. Anti-TNF agents for the treatment of psoriasis. J Drugs Dermatol 2009; 8(6): 546-59.
[PMID: 19537380]
Balato A, Schiattarella M, Di Caprio R, et al. Effects of adalimumab therapy in adult subjects with moderate-to-severe psoriasis on Th17 pathway. J Eur Acad Dermatol Venereol 2014; 28(8): 1016-24.
[] [PMID: 24033358]
Kellen R, Goldenberg G. Biosimilars in psoriasis: the future or not? Cutis 2017; 99(2): 116-20.
[PMID: 28319617]
Campanati A, Orciani M, Ganzetti G, Consales V, Di Primio R, Offidani A. The effect of etanercept on vascular endothelial growth factor production by cutaneous mesenchymal stem cells from patients with psoriasis. J Int Med Res 2016; 44(1): 6-9.
[] [PMID: 27683131]
Boehncke S, Salgo R, Garbaraviciene J, et al. Effective continuous systemic therapy of severe plaque-type psoriasis is accompanied by amelioration of biomarkers of cardiovascular risk: results of a prospective longitudinal observational study. J Eur Acad Dermatol Venereol 2011; 25(10): 1187-93.
[] [PMID: 21241371]
Marra M, Campanati A, Testa R, et al. Effect of etanercept on insulin sensitivity in nine patients with psoriasis. Int J Immunopathol Pharmacol 2007; 20(4): 731-6.
[] [PMID: 18179745]
Pina T, Armesto S, Lopez-Mejias R, et al. Anti-TNF-α therapy improves insulin sensitivity in non-diabetic patients with psoriasis: a 6-month prospective study. J Eur Acad Dermatol Venereol 2015; 29(7): 1325-30.
[] [PMID: 25353352]
Pina T, Genre F, Lopez-Mejias R, et al. Anti-TNF-α therapy reduces retinol-binding protein 4 serum levels in non-diabetic patients with psoriasis: a 6-month prospective study. J Eur Acad Dermatol Venereol 2016; 30(1): 92-5.
[] [PMID: 25650695]
Jókai H, Szakonyi J, Kontár O, et al. Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis: results of a pilot study. J Am Acad Dermatol 2013; 69(4): 523-9.
[] [PMID: 23891393]
Bissonnette R, Tardif JC, Harel F, Pressacco J, Bolduc C, Guertin MC. Effects of the tumor necrosis factor-α antagonist adalimumab on arterial inflammation assessed by positron emission tomography in patients with psoriasis: results of a randomized controlled trial. Circ Cardiovasc Imaging 2013; 6(1): 83-90.
[] [PMID: 23204039]
Armstrong AW. Do TNF inhibitors reduce the risk of myocardial infarction in psoriasis patients? JAMA 2013; 309(19): 2043-4.
[] [PMID: 23677316]
Hjuler KF, Bøttcher M, Vestergaard C, Bøtker HE, Iversen L, Kragballe K. Association between changes in coronary artery disease progression and treatment with biologic agents for severe psoriasis. JAMA Dermatol 2016; 152(10): 1114-21.
[] [PMID: 27385305]
Ahlehoff O, Hansen PR, Gislason GH, et al. Myocardial function and effects of biologic therapy in patients with severe psoriasis: a prospective echocardiographic study. J Eur Acad Dermatol Venereol 2016; 30(5): 819-23.
[] [PMID: 25845841]
Herédi E, Végh J, Pogácsás L, et al. Subclinical cardiovascular disease and it’s improvement after long-term TNF-α inhibitor therapy in severe psoriatic patients. J Eur Acad Dermatol Venereol 2016; 30(9): 1531-6.
[] [PMID: 27393182]
Wu JJ, Poon KY, Channual JC, Shen AY. Association between tumor necrosis factor inhibitor therapy and myocardial infarction risk in patients with psoriasis. Arch Dermatol 2012; 148(11): 1244-50.
[] [PMID: 22911151]
Wu JJ, Guérin A, Sundaram M, Dea K, Cloutier M, Mulani P. Cardiovascular event risk assessment in psoriasis patients treated with tumor necrosis factor-α inhibitors versus methotrexate. J Am Acad Dermatol 2017; 76(1): 81-90.
[] [PMID: 27894789]
Chung ES, Packer M, Lo KH, Fasanmade AA, Willerson JT. Randomized, double-blind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF therapy against congestive heart failure (ATTACH) trial. Circulation 2003; 107(25): 3133-40.
[] [PMID: 12796126]
Mann DL, McMurray JJ, Packer M, et al. Targeted anticytokine therapy in patients with chronic heart failure: results of the randomized etanercept worldwide evaluation (RENEWAL). Circulation 2004; 109(13): 1594-602.
[] [PMID: 15023878]
Pham T, Bachelez H, Berthelot JM, et al. TNF alpha antagonist therapy and safety monitoring. Joint Bone Spine 2011; 78(Suppl. 1): 15-185.
[] [PMID: 21703545]
Gisondi P, Cotena C, Tessari G, Girolomoni G. Anti-tumour necrosis factor-alpha therapy increases body weight in patients with chronic plaque psoriasis: a retrospective cohort study. J Eur Acad Dermatol Venereol 2008; 22(3): 341-4.
[] [PMID: 18005022]
Rungapiromnan W, Yiu ZZN, Warren RB, Griffiths CEM, Ashcroft DM. Impact of biologic therapies on risk of major adverse cardiovascular events in patients with psoriasis: systematic review and meta-analysis of randomized controlled trials. Br J Dermatol 2017; 176(4): 890-901.
[] [PMID: 27518205]
Caiazzo G, Fabbrocini G, Di Caprio R, et al. Psoriasis, cardiovascular events, and biologics: lights and shadows. Front Immunol 2018; 9: 1668.
[] [PMID: 30150978]
Gelfand JM, Berlin J, Van Voorhees A, Margolis DJ. Lymphoma rates are low but increased in patients with psoriasis: results from a population-based cohort study in the United Kingdom. Arch Dermatol 2003; 139(11): 1425-9.
[] [PMID: 14623702]
Gelfand JM, Shin DB, Neimann AL, Wang X, Margolis DJ, Troxel AB. The risk of lymphoma in patients with psoriasis. J Invest Dermatol 2006; 126(10): 2194-201.
[] [PMID: 16741509]
Margolis D, Bilker W, Hennessy S, Vittorio C, Santanna J, Strom BL. The risk of malignancy associated with psoriasis. Arch Dermatol 2001; 137(6): 778-83.
[PMID: 11405770]
Bongartz T, Sutton AJ, Sweeting MJ, et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA 2006; 295(19): 2275-85.
Patel RV, Clark LN, Lebwohl M, Weinberg JM. Treatments for psoriasis and the risk of malignancy. J Am Acad Dermatol 2009; 60(6): 1001-17.
[] [PMID: 19344980]
Lopez-Olivo MA, Tayar JH, Martinez-Lopez JA, et al. Risk of malignancies in patients with rheumatoid arthritis treated with biologic therapy: a meta-analysis. JAMA 2012; 308(9): 898-908.
[] [PMID: 22948700]
Dommasch ED, Abuabara K, Shin DB, Nguyen J, Troxel AB, Gelfand JM. The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials. J Am Acad Dermatol 2011; 64(6): 1035-50.
[] [PMID: 21315483]
Pariser DM, Leonardi CL, Gordon K, et al. Integrated safety analysis: short- and long-term safety profiles of etanercept in patients with psoriasis. J Am Acad Dermatol 2012; 67(2): 245-56.
[] [PMID: 22015149]
Kimball AB, Rothman KJ, Kricorian G, et al. OBSERVE-5: observational postmarketing safety surveillance registry of etanercept for the treatment of psoriasis final 5-year results. J Am Acad Dermatol 2015; 72(1): 115-22.
[] [PMID: 25264239]
Fiorentino D, Ho V, Lebwohl MG, et al. Risk of malignancy with systemic psoriasis treatment in the psoriasis longitudinal assessment registry. J Am Acad Dermatol 2017; 77(5): 845-54.
[] [PMID: 28893407]
deShazo R, Soltani-Arabshahi R, Krishnasamy S, et al. Non-melanoma skin cancer risk among patients in the psoriasis longitudinal assessment and registry (PSOLAR). J Drugs Dermatol 2019; 18(10): 1059-60.
[PMID: 31603636]
Asgari MM, Ray GT, Geier JL, Quesenberry CP. Malignancy rates in a large cohort of patients with systemically treated psoriasis in a managed care population. J Am Acad Dermatol 2017; 76(4): 632-8.
[] [PMID: 28162854]
Peleva E, Exton LS, Kelley K, Kleyn CE, Mason KJ, Smith CH. Risk of cancer in patients with psoriasis on biological therapies: a systematic review. Br J Dermatol 2018; 178(1): 103-13.
[] [PMID: 28722163]
Mercer LK, Askling J, Raaschou P, et al. Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers. Ann Rheum Dis 2017; 76(2): 386-91.
[] [PMID: 27307502]
Ballegaard C, Hellgren K, Cordtz R, et al. Incidence of overall and site-specific cancers in TNF inhibitor treated patients with psoriatic arthritis: a population-based cohort study from 4 Nordic countries. Ann Rheum Dis 2019; 78(Suppl. 2): 67-8. Available from:
Hellgren K, Smedby KE, Backlin C, et al. Ankylosing spondylitis, psoriatic arthritis, and risk of malignant lymphoma: a cohort study based on nationwide prospectively recorded data from Sweden. Arthritis Rheumatol 2014; 66(5): 1282-90.
[] [PMID: 24782185]
Baecklund E, Iliadou A, Askling J, et al. Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis. Arthritis Rheum 2006; 54(3): 692-701.
[] [PMID: 16508929]
Mercer LK, Regierer AC, Mariette X, et al. Spectrum of lymphomas across different drug treatment groups in rheumatoid arthritis: a European registries collaborative project. Ann Rheum Dis 2017; 76(12): 2025-30.
[] [PMID: 28822981]
Mercer LK, Galloway JB, Lunt M, et al. Risk of lymphoma in patients exposed to antitumour necrosis factor therapy: results from the British society for rheumatology biologics register for rheumatoid arthritis. Ann Rheum Dis 2017; 76(3): 497-503.
[] [PMID: 27502891]
Reddy SP, Martires K, Wu JJ. The risk of melanoma and hematologic cancers in patients with psoriasis. J Am Acad Dermatol 2017; 76(4): 639-47.
[] [PMID: 27876302]
Geller S, Xu H, Lebwohl M, Nardone B, Lacouture ME, Kheterpal M. Malignancy risk and recurrence with psoriasis and its treatments: a concise update. Am J Clin Dermatol 2018; 19(3): 363-75.
[] [PMID: 29260411]
Patel S, Patel T, Kerdel FA. The risk of malignancy or progression of existing malignancy in patients with psoriasis treated with biologics: case report and review of the literature. Int J Dermatol 2016; 55(5): 487-93.
[] [PMID: 26711080]
Dommasch E, Gelfand JM. Is there truly a risk of lymphoma from biologic therapies? Dermatol Ther 2009; 22(5): 418-30.
[] [PMID: 19845719]
Wolinsky C, Lebwohl M. Biologic therapy and the risk of malignancy in psoriasis. Psoriasis Forum 2011; 17(4): 238-53.
Novosad SA, Winthrop KL. Beyond tumor necrosis factor inhibition: the expanding pipeline of biologic therapies for inflammatory diseases and their associated infectious sequelae. Clin Infect Dis 2014; 58(11): 1587-98.
[] [PMID: 24585557]
Kalb RE, Fiorentino DF, Lebwohl MG, et al. Risk of serious infection with biologic and systemic treatment of psoriasis: results from the psoriasis longitudinal assessment and registry (PSOLAR). JAMA Dermatol 2015; 151(9): 961-9.
[] [PMID: 25970800]
Minozzi S, Bonovas S, Lytras T, et al. Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. Expert Opin Drug Saf 2016; 151: 11-34.
Dávila-Seijo P, Dauden E, Descalzo MA, et al. Infections in moderate to severe psoriasis patients treated with biological drugs compared to classic systemic drugs: findings from the BIOBADADERM Registry. J Invest Dermatol 2017; 137(2): 313-21.
[] [PMID: 27677836]
Garcia-Doval I, Cohen AD, Cazzaniga S, et al. Risk of serious infections, cutaneous bacterial infections, and granulomatous infections in patients with psoriasis treated with anti-tumor necrosis factor agents versus classic therapies: Prospective meta-analysis of Psonet registries. J Am Acad Dermatol 2017; 76(2): 299-308.
[] [PMID: 27693008]
Yiu ZZN, Smith CH, Ashcroft DM, et al. Risk of serious infection in patients with psoriasis receiving biologic therapies: a prospective cohort study from the british association of dermatologists biologic interventions register (BADBIR). J Invest Dermatol 2018; 138(3): 534-41.
[] [PMID: 29054603]
Dommasch ED, Kim SC, Lee MP, Gagne JJ. Risk of serious infection in patients receiving systemic medications for the treatment of psoriasis. JAMA Dermatol 2019; 155(10): 1142-52.
[] [PMID: 31075163]
Garcia-Doval I, Hernandez MV, Vanaclocha F, et al. Should TNF-antagonists safety information be applied from patients with rheumatoid arthritis to psoriasis? Rates of serious adverse events in the prospective rheumatoid arthritis Biobadaser and psoriasis BIOBADADERM cohorts. Br J Dermatol 2017; 176: 643-9.
[] [PMID: 27258623]
Murdaca G, Negrini S, Pellecchio M, et al. Update upon the infection risk in patients receiving TNF alpha inhibitors. Expert Opin Drug Saf 2019; 18(3): 219-29.
[] [PMID: 30704314]
Luger D, Silver PB, Tang J, et al. Either a Th17 or a Th1 effector response can drive autoimmunity: conditions of disease induction affect dominant effector category. J Exp Med 2008; 205(4): 799-810.
[] [PMID: 18391061]
Lee E, Trepicchio WL, Oestreicher JL, et al. Increased expression of interleukin 23 p19 and p40 in lesional skin of patients with psoriasis vulgaris. J Exp Med 2004; 199(1): 125-30.
[] [PMID: 14707118]
Chan JR, Blumenschein W, Murphy E, et al. IL-23 stimulates epidermal hyperplasia via TNF and IL-20R2-dependent mechanisms with implications for psoriasis pathogenesis. J Exp Med 2006; 203(12): 2577-87.
[] [PMID: 17074928]
Uyemura K, Demer LL, Castle SC, et al. Cross-regulatory roles of interleukin (IL)-12 and IL-10 in atherosclerosis. J Clin Invest 1996; 97(9): 2130-8.
[] [PMID: 8621803]
Correia LC, Andrade BB, Borges VM, et al. Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes. Clin Chim Acta 2010; 411(7-8): 540-5.
[] [PMID: 20083097]
Yong K, Dogra G, Boudville N, et al. Interleukin-12 is associated with arterial stiffness in healthy individuals. Am J Hypertens 2013; 26(2): 159-62.
[] [PMID: 23382399]
Abbas A, Gregersen I, Holm S, et al. Interleukin 23 levels are increased in carotid atherosclerosis: possible role for the interleukin 23/interleukin 17 axis. Stroke 2015; 46(3): 793-9.
[] [PMID: 25649806]
Mitra A, Fallen RS, Lima HC. Cytokine-based therapy in psoriasis. Clin Rev Allergy Immunol 2013; 44(2): 173-82.
[] [PMID: 22426927]
Leonardi CL, Kimball AB, Papp KA, et al. PHOENIX 1 study investigators. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet 2008; 371(9625): 1665-74.
[] [PMID: 18486739]
Papp KA, Leonardi C, Menter A, et al. Brodalumab, an anti-interleukin-17-receptor antibody for psoriasis. N Engl J Med 2012; 366(13): 1181-9.
[] [PMID: 22455412]
Gordon KB, Langley RG, Gottlieb AB, et al. A phase III, randomized, controlled trial of the fully human IL-12/23 mAb briakinumab in moderate-to-severe psoriasis. J Invest Dermatol 2012; 132(2): 304-14.
[] [PMID: 22011907]
Gottlieb AB, Leonardi C, Kerdel F, Mehlis S, Olds M, Williams DA. Efficacy and safety of briakinumab vs. etanercept and placebo in patients with moderate to severe chronic plaque psoriasis. Br J Dermatol 2011; 165(3): 652-60.
[] [PMID: 21574983]
Strober BE, Crowley JJ, Yamauchi PS, Olds M, Williams DA. Efficacy and safety results from a phase III, randomized controlled trial comparing the safety and efficacy of briakinumab with etanercept and placebo in patients with moderate to severe chronic plaque psoriasis. Br J Dermatol 2011; 165(3): 661-8.
[] [PMID: 21574984]
Kimball AB, Gordon KB, Langley RG, Menter A, Perdok RJ, Valdes J. ABT-874 Study Investigators Efficacy and safety of ABT-874, a monoclonal anti-interleukin 12/23 antibody, for the treatment of chronic plaque psoriasis: 36-week observation/retreatment and 60-week open-label extension phases of a randomized phase II trial. J Am Acad Dermatol 2011; 64(2): 263-74.
[] [PMID: 21145618]
Reich K, Langley RG, Lebwohl M, et al. Cardiovascular safety of ustekinumab in patients with moderate to severe psoriasis: results of integrated analyses of data from phase II and III clinical studies. Br J Dermatol 2011; 164(4): 862-72.
[] [PMID: 21332467]
Ryan C, Leonardi CL, Krueger JG, et al. Association between biologic therapies for chronic plaque psoriasis and cardiovascular events: a meta-analysis of randomized controlled trials. JAMA 2011; 306(8): 864-71.
[] [PMID: 21862748]
Tzellos T, Kyrgidis A, Zouboulis CC. Re-evaluation of the risk for major adverse cardiovascular events in patients treated with anti-IL-12/23 biological agents for chronic plaque psoriasis: a meta-analysis of randomized controlled trials. J Eur Acad Dermatol Venereol 2013; 27(5): 622-7.
[] [PMID: 22404103]
Kimball AB, Papp KA, Wasfi Y, et al. Long-term efficacy of ustekinumab in patients with moderate-to-severe psoriasis treated for up to 5 years in the PHOENIX 1 study. J Eur Acad Dermatol Venereol 2013; 27(12): 1535-45.
[] [PMID: 23279003]
Ikonomidis I, Papadavid E, Makavos G, et al. Lowering interleukin-12 activity improves myocardial and vascular function compared with tumor necrosis factor-a antagonism or cyclosporine in psoriasis. Circ Cardiovasc Imaging 2017; 10(9): e006283.
[] [PMID: 28899951]
Kagami S, Rizzo HL, Lee JJ, Koguchi Y, Blauvelt A. Circulating Th17, Th22, and Th1 cells are increased in psoriasis. J Invest Dermatol 2010; 130(5): 1373-83.
[] [PMID: 20032993]
Chen S, Crother TR, Arditi M. Emerging role of IL-17 in atherosclerosis. J Innate Immun 2010; 2(4): 325-33.
[] [PMID: 20505315]
Taleb S, Romain M, Ramkhelawon B, et al. Loss of SOCS3 expression in T cells reveals a regulatory role for interleukin-17 in atherosclerosis. J Exp Med 2009; 206(10): 2067-77.
[] [PMID: 19737863]
Eid RE, Rao DA, Zhou J, et al. Interleukin-17 and interferon-gamma are produced concomitantly by human coronary artery-infiltrating T cells and act synergistically on vascular smooth muscle cells. Circulation 2009; 119(10): 1424-32.
[] [PMID: 19255340]
Taleb S, Tedgui A, Mallat Z. IL-17 and Th17 cells in atherosclerosis: subtle and contextual roles. Arterioscler Thromb Vasc Biol 2015; 35(2): 258-64.
[] [PMID: 25234818]
Golden JB, McCormick TS, Ward NL. IL-17 in psoriasis: implications for therapy and cardiovascular co-morbidities. Cytokine 2013; 62(2): 195-201.
[] [PMID: 23562549]
Balato A, Scala E, Balato N, et al. Biologics that inhibit the Th17 pathway and related cytokines to treat inflammatory disorders. Expert Opin Biol Ther 2017; 17(11): 1363-74.
[] [PMID: 28791896]
van de Kerkhof PC, Griffiths CE, Reich K, et al. Secukinumab long-term safety experience: A pooled analysis of 10 phase II and III clinical studies in patients with moderate to severe plaque psoriasis. J Am Acad Dermatol 2016; 75(1): 83-98.
[] [PMID: 27180926]
Wu D, Hou SY, Zhao S, et al. Efficacy and safety of interleukin-17 antagonists in patients with plaque psoriasis: a meta-analysis from phase 3 randomized controlled trials. J Eur Acad Dermatol Venereol 2017; 31(6): 992-1003.
[] [PMID: 28107570]
von Stebut E, Reich K, Thaçi D, et al. Impact of secukinumab on endothelial dysfunction and other cardiovascular disease parameters in psoriasis patients over 52 weeks. J Invest Dermatol 2019; 139(5): 1054-62.
[] [PMID: 30508547]
Deodhar A, Mease PJ, McInnes IB, et al. Long-term safety of secukinumab in patients with moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis: integrated pooled clinical trial and post-marketing surveillance data. Arthritis Res Ther 2019; 21(1): 111.
[] [PMID: 31046809]
Reich K, Warren RB, Coates LC, Di Comite G. Long-term efficacy and safety of secukinumab in the treatment of the multiple manifestations of psoriatic disease. J Eur Acad Dermatol Venereol 2020; 34(6): 1161-73.
[]] [PMID: 31785165]
Gordon KB, Colombel JF, Hardin DS. Phase 3 Trials of Ixekizumab in Moderate-to-Severe Plaque Psoriasis. N Engl J Med 2016; 375(21): 2102.
[] [PMID: 27959738]
Strober B, Leonardi C, Papp KA, et al. Short- and long-term safety outcomes with ixekizumab from 7 clinical trials in psoriasis: Etanercept comparisons and integrated data. J Am Acad Dermatol 2017; 76(3): 432.
[] [PMID: 27889292]
Lebwohl M, Strober B, Menter A, et al. Phase 3 Studies Comparing Brodalumab with Ustekinumab in Psoriasis. N Engl J Med 2015; 373(14): 1318-28.
[] [PMID: 26422722]
Champs B, Degboé Y, Barnetche T, Cantagrel A, Ruyssen-Witrand A, Constantin A. Short-term risk of major adverse cardiovascular events or congestive heart failure in patients with psoriatic arthritis or psoriasis initiating a biological therapy: a meta-analysis of randomised controlled trials. RMD Open 2019; 5(1): e000763.
[] [PMID: 30792887]
Rungapiromnan W, Mason KJ, Lunt M, et al. Risk of major cardiovascular events in patients with psoriasis receiving biologic therapies: a prospective cohort study. J Eur Acad Dermatol Venereol 2020; 34(4): 769-78.
[] [PMID: 31633837]
Elnabawi YA, Dey AK, Goyal A, et al. Coronary artery plaque characteristics and treatment with biologic therapy in severe psoriasis: results from a prospective observational study. Cardiovasc Res 2019; 115(4): 721-8.
[] [PMID: 30721933]
Makavos G, Ikonomidis I, Andreadou I, et al. Effects of interleukin 17a inhibition on myocardial deformation and vascular function in psoriasis. Can J Cardiol 2020; 36(1): 100-11.
[] [PMID: 31606265]
Leisner MZ, Lindorff Riis J, Gniadecki R, Iversen L, Olsen M. Psoriasis and risk of myocardial infarction before and during an era with biological therapy: a population-based follow-up study. J Eur Acad Dermatol Venereol 2018; 32(12): 2185-90.
[] [PMID: 29719939]
Nast A, Gisondi P, Ormerod AD, et al. European s3-guidelines on the systemic treatment of psoriasis vulgaris--update 2015--short version--edf in cooperation with eadv and ipc. J Eur Acad Dermatol Venereol 2015; 29(12): 2277-94.
[] [PMID: 26481193]
Coates LC, Kavanaugh A, Mease PJ, et al. Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis. Arthritis Rheumatol 2016; 68(5): 1060-71.
[] [PMID: 26749174]
Dauden E, Blasco AJ, Bonanad C, et al. Position statement for the management of comorbidities in psoriasis. J Eur Acad Dermatol Venereol 2018; 32(12): 2058-73.
[] [PMID: 29992631]

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2020
Page: [592 - 609]
Pages: 18
DOI: 10.2174/1570161118666200523154318
Price: $65

Article Metrics

PDF: 61
HTML: 10