Background The risk of CV events is closely related to the severity of the psoriasis. The presence of severe psoriasis confers an additional 6.2% absolute risk of a 10-year rate of CV events compared with the general population. Studies on anti-TNF-α therapy indicate that these agents yield a reduction in the incidence of CV events in patients with psoriasis.
Objectives To determine if the use of the anti-TNF-α monoclonal antibody adalimumab could improve endothelial function and arterial stiffness in patients with moderate-to-severe psoriasis.
Methods Prospective study on a series of consecutive patients with moderate-to-severe psoriasis who completed 6 months of therapy with adalimumab. Patients with history of cardiovascular events, diabetes mellitus, kidney disease, hypertension or body mass index ≥35 kg/m2 were excluded. Assessment of endothelial function by brachial artery reactivity measuring flow-mediated endothelial dependent vasodilatation (FMD%), and carotid arterial stiffness by pulse wave velocity (PWV) was performed at the onset of treatment (time 0) and at month 6.
Results 29 patients were studied. Anti-TNF-α adalimumab therapy yielded a significant improvement of endothelial function. The mean±standard deviation (SD) FMD% values increased from 6.19±2.44% at the onset of adalimumab to 7.46±2.43% after six months of treatment with this biologic agent (p=0.008). Likewise, following the use of adalimumab, PWV levels decreased from 6.28±1.04 m/s at the onset of adalimumab to 5.69±1.31 m/s at 6 months (p=0.03).
Conclusions Patients with moderate-to-severe psoriasis exhibit improvement of endothelial function and arterial stiffness following anti-TNF-α therapy. These findings are of potential relevance due to increased risk of cardiovascular disease in patients with severe psoriasis.
Acknowledgement The study was supported by a research grant from Abbvie Inc.
Disclosure of Interest None declared
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