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Anti‐inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis
Author(s) -
Wu J.J.,
Joshi A.A.,
Reddy S.P.,
Batech M.,
Egeberg A.,
Ahlehoff O.,
Mehta N.N.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.14951
Subject(s) - medicine , mace , psoriasis , cohort , hazard ratio , retrospective cohort study , proportional hazards model , cohort study , risk factor , adverse effect , surgery , dermatology , myocardial infarction , percutaneous coronary intervention , confidence interval
Background Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. Objective To determine whether tumour necrosis factor inhibitor ( TNF i) therapy is associated with decreased major adverse cardiovascular events ( MACE ) in patients with psoriasis. Methods In this retrospective cohort study using the KPSC health plan, patients had at least three ICD ‐9 codes for psoriasis and no antecedent MACE codes. Propensity score‐adjusted multivariable Cox regression assessed hazard ratios ( HR ) of MACE associated with TNF i use. Results After adjusting for cardiovascular risk factors, the TNF i cohort had significantly lower MACE HR compared with the topical cohort ( HR , 0.80; 95% CI , 0.66–0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort ( HR , 1.19 (95% CI , 0.99–1.42)). Conclusions We observed significantly lower MACE risk in patients with psoriasis receiving TNF i compared to topical or oral/phototherapy agents. TNF i therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.