Clinical Edge

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TNFi, Less Carotid Plaque Link in Psoriatic Disease

Arthritis Rheumatol; ePub 2017 Oct 31; Eder, et al

TNF-α inhibitor treatment (TNFi) was associated with reduced progression of carotid plaques in men and improvement in vascular inflammation in psoriatic patients, a recent study found. Researchers first assessed carotid total plaque area by ultrasound at baseline and after 2-3 years in patients with psoriasis and psoriatic arthritis (PsA) (n=319). In stage 2, they studied vascular inflammation using FDG PET/CT in PsA patients on TNFi (n=21) and age and sex matched PsA patients not on any biologics (n=13). This sample underwent FDG PET/CT scans at baseline and 1 year to assess vascular inflammation, measured as target-to-background ratio (TBR). They found:

  • In the first stage, men had a significantly higher atherosclerosis progression compared to women.
  • TNFi was associated with a reduced atherosclerosis progression in men, after controlling for cardiovascular risk and statins.
  • However, there was no association between TNFi and atherosclerosis progression in women.
  • In the second stage, at 1 year, patients on TNFi had a reduction in TBR.
Citation:

Eder L, Joshi AA, Dey AK, et al.  TNF-α inhibitors are associated with reduced indices of subclinical atherosclerosis in patients with psoriatic disease. [Published online ahead of print October 31, 2017]. Arthritis Rheumatol. doi:10.1002/art.40366.

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