How can psoriasis and heart disease be treated at the same time?

Patients with psoriasis treated with biologic therapy – protein-based infusions that suppress inflammation – had a significant reduction in coronary plaque after a period of one year.

Chronic inflammation in people with psoriasis is associated with an increased risk of developing coronary heart disease. Biological therapy drugs are proteins that are given by injection or infusion and suppress the process of inflammation by blocking the action of cytokines, which are proteins that promote systemic inflammation.

Previous research has shown a clear link between psoriasis and the development of high-risk coronary heart disease. This study provides the characterization of a lipid-rich necrotic nucleus, a dangerous type of coronary plaque made up of dead cells and cell debris that is prone to eruption. The erupted plaque can lead to a heart attack or stroke.

“Having an inflamed plaque that is prone to rash increases the risk of a heart attack up to five times in ten years,” said Nehal N. Mehta, lead author of the study.

This is the first time that an imaging study has shown what can cause a year of ongoing, untreated inflammation in the heart. And fortunately, we can reverse this damage.

The analysis involved a number of 209 middle-aged patients – aged 37-62 – with psoriasis who participated in the Psoriasis Atherosclerosis Cardiometabolic Initiative at the National Institutes of Health, a study ongoing observation.

Of these participants, 124 received biologic therapy and 85 were in the control group, treated only with topical creams and light therapy.

To measure the effects of biologic therapy on the arteries of the heart, the researchers performed computed tomography (CT) scans of all study participants before and at the end of therapy. The CT results between the two groups were then compared.

At the start of the study, participants with psoriasis had a lower cardiovascular risk than conventional cardiovascular risk scores, and severe psoriasis was associated with a higher body mass index (BMI), a high sensitivity of protein C reactive (a measure of systemic inflammation) and higher levels of coronary artery plaque.

However, the findings of the study should be interpreted with caution, as they were limited by a short period of observation and a relatively small number of patients.

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