Lower MI Risk With TNF Inhibitor Therapy for Psoriasis
Compared to topical agents, TNF inhibitor treatment tied to lower risk, incidence of heart attack
WEDNESDAY, Aug. 22 (HealthDay News) -- Patients with psoriasis who are treated with tumor necrosis factor (TNF) inhibitors have a significantly lower risk and incidence of myocardial infarction (MI) compared with those who are treated with topical agents, according to a study published online Aug. 20 in the Archives of Dermatology.
Jashin J. Wu, M.D., of the Kaiser Permanente Los Angeles Medical Center, and colleagues conducted a retrospective cohort study involving 8,845 patients to examine the risk of MI associated with TNF inhibitor treatment. The participants included a TNF cohort of 1,673 patients treated with a TNF inhibitor for at least two months; an oral/phototherapy cohort of 2,097 TNF inhibitor-naive patients who received phototherapy or other systemic agents; and a topical cohort of 5,075 who were not treated with TNF inhibitors, systemic therapies, or phototherapy.
After a median follow-up of 4.3 years, and with a medium duration of TNF inhibitor therapy of 685 days, the researchers found that the TNF inhibitor cohort displayed a significantly lower risk of MI compared with those who were treated with topical agents, after adjustment for MI risk factors (adjusted hazard ratio, 0.50). The overall incidence of MI was 3.05, 3.85, and 6.73 per 1,000 patient-years in the TNF inhibitor, oral/phototherapy, and topical cohorts, respectively.
"Use of TNF inhibitors for psoriasis was associated with a significant reduction in MI risk and incident rate compared with treatment with topical agents," the authors write. "Use of TNF inhibitors for psoriasis was associated with a non-statistically significant lower MI incident rate compared with treatment with oral agents/phototherapy."
One author disclosed financial ties to pharmaceutical companies.