• Plaque in the arteries of people with psoriasis increases the risk of coronary artery disease
• Treatment with biologic therapy reduced coronary plaque by 6% to 8% after one year
• This is as effective as statin therapy on heart arteries

Biologic therapy for the skin condition psoriasis may reduce patients’ risk of heart disease, new research suggests.

Chronic inflammation in people with psoriasis is associated with the development of plaque in heart arteries, which increases the risk of coronary artery disease. In biologic therapy, patients receive protein-based infusions to reduce inflammation.

“This is the first time an imaging study in humans has shown what one year of ongoing, untreated inflammation can do to arteries of the heart, and that we can reverse this damage,” said study senior author Dr Nehal Mehta. He’s chief of the inflammation and cardiometabolic diseases lab at the US National Heart, Lung, and Blood Institute.

Prone to rupture

“Untreated inflammation is dangerous. You are just waiting for a heart attack or stroke to happen,” Mehta added.

This study focused on a dangerous type of coronary plaque called lipid-rich necrotic core. It’s composed of dead cells and cell debris, and is prone to rupture. Ruptured plaque can lead to a heart attack or stroke.

The study included 209 patients, aged 37 to 62, with psoriasis. They were selected to receive biologic therapy (124 patients) or assigned to the control group and received topical creams and light therapy (85 patients).

After one year of treatment, CT scans showed that patients who received biologic therapy had an 8% decrease in coronary plaque, while those in the control group had a slight increase.

The findings held even after the researchers adjusted for cardiovascular risk factors and psoriasis severity. The study was published on 15 September in the journal Circulation: Cardiovascular Imaging.

Just as beneficial as statin therapy

“Having inflamed plaque that is prone to rupture increases the risk of heart attack fivefold within 10 years,” Mehta said in a journal news release.

Treatment with cholesterol-lowering statins reduces coronary plaque approximately 6% to 8%, Mehta noted. “Similarly, our treatment with biologic therapy reduced coronary plaque by the same amount after one year. These findings suggest that biologic therapy to treat psoriasis may be just as beneficial as statin therapy on heart arteries,” he added.

Along with psoriasis patients, the study findings could have implications for people with other chronic inflammatory conditions such as HIV, lupus and rheumatoid arthritis, who also have an increased risk of heart disease, according to the researchers.

“We have never before been able to show healing of an inflamed plaque like this in humans. Biologic therapy reduces systemic inflammation and immune activation, and it has a favourable impact on improving overall vascular health,” Mehta said.

The authors said a larger study is needed to confirm the results.

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