Psoriasis Tx Linked to Drop in Noncalcified Coronary Plaque
Noncalcified plaque burden and necrotic core reduced in association with biologic therapy
WEDNESDAY, Feb. 6, 2019 (Pharmacist's Briefing) -- Treatment of psoriasis with biologic therapy is associated with a reduction in noncalcified coronary plaque and improved plaque morphology, according to a study published online Feb. 5 in Cardiovascular Research.
Youssef A. Elnabawi, from the National Institutes of Health in Bethesda, Maryland, and colleagues recruited 290 participants from Jan. 1, 2013, through Dec. 31, 2018, in a prospective observational study. Total coronary plaque burden and plaque subcomponents were quantified in three main coronary vessels >2 mm.
The researchers observed a 6 percent reduction in noncalcified plaque burden and a reduction in necrotic core in association with biologic therapy, with no effect on fibrous burden. When comparing the change in plaque characteristics between the groups over one year, they found the biologic-treated group had a significant decrease in noncalcified plaque burden compared with slow plaque progression in the non-biologic-treated group (Δ, −0.07 versus 0.06 mm²); this association persisted even after adjustment for traditional cardiovascular risk factors.
"The findings that intrigued us most were that coronary plaque subcomponents changed over one year, including the necrotic core and noncalcified components, which are the culprits for most heart attacks," a coauthor said in a statement. "This appears to be an anti-inflammatory effect. In the absence of improvement in other cardiovascular risk factors, and without adding new cholesterol medications, patients' soft-plaque still improved. The only change was the severity of their skin disease."
Two authors disclosed financial ties to the pharmaceutical industry; the study was funded in part by the Colgate-Palmolive Co. and Genentech.