TDNet Discover

Background: Psoriasis is a chronic multisystem inflammatory disorder that is primarily known for its effect on the skin. Psoriasis has been estimated to affect 3% of the US population and 125 million people worldwide. Plaque psoriasis is the most common variant, accounting for more than 80% of the psoriasis cases. Even though psoriasis is physically seen as a dermatological manifestation, this disease can affect other systems including the cardiovascular system. There is no cure for psoriasis; however, there are several medications that can be prescribed to help alleviate symptoms. Psoriasis can be treated with either topical therapies, systemic therapies, or a combination of both. Purpose: The purpose of this research was to understand how psoriasis and the different types of psoriasis medications affect the cardiovascular system and if certain medications are useful as therapy against cardiovascular disease that may occur alongside psoriasis. Methods: We searched through PubMed, Google Scholar, and CINAHL Ultimate for articles that reported on the association between psoriasis and psoriatic therapies on cardiovascular health. All abstracts, full-text articles, and sources were reviewed with duplicate data excluded using a criteria checklist. A quality assessment tool from the National Heart, Lung, and Blood Institute (NHLBI) was used to determine the quality of the selected studies and only studies rated “good” were included in the research. Lastly, a data extraction tool was utilized to perform the qualitative analysis of the included studies. Results: We identified 32 articles, of these 10 unique abstracts underwent full-text review. We finally selected 3 out of these 10 studies comprising 4,895,857 psoriasis patients. Systemic antipsoriatic therapy was linked to a significant decrease in risk of all CVEs in psoriasis/psoriatic arthritis (RR, 0.75; 95% CI 0.63 to 0.91; p=0.003). Systemic methotrexate (HR: 0.76; 95% CI: v 0.61–0.94) was associated with lower risks of composite cardiovascular outcomes (hospitalization for ischemic heart disease, ischemic stroke, and/or all-cause mortality) in comparison with systemic retinoids (HR: 0.80; 95% CI: 0.62–1.04). Atrial fibrillation risk was significantly higher in patients with psoriasis (RR: 1.39; 95% CI: 1.257-1.523; P < 0.0001), patients age >50 (RR: 1.170; 95% CI: 1.096-1.249; P = 0.129), and patients with severe psoriasis (RR: 1.634; 95% CI: 1.490-1.791). Conclusion: The findings of this research demonstrate that systemic psoriasis therapies significantly decreased the risk of all cardiovascular events in patients with psoriasis and that atrial fibrillation risk was significantly higher in patients with psoriasis. Educating healthcare providers on this link between psoriasis treatment and cardiovascular health is crucial to reducing, and ultimately preventing, morbidity and mortality in patients with psoriasis. Future studies regarding effects of systemic anti-psoriatic medications and their outcomes across various psoriasis patient populations and settings would help provide in standardizing care. Ultimately, research that is supplemental in building standardized evidence-based treatment and multidisciplinary care for psoriasis patients could prevent morbidity and mortality in these patients, leading to lessening the burden on patients and on US healthcare.