Biologics Treat More Than Skin Disease


Biologic therapies may reduce coronary plaques in patients with psoriasis, according to the findings of a recent study.1


“Psoriasis severity is related to the burden of coronary disease – our findings suggest treating the psoriasis may potentially benefit coronary heart disease,” said corresponding author Nehal Mehta, MD, MSCE, FAHA, chief of inflammation and cardiometabolic diseases at the National Heart, Lung, and Blood Institute with the National Institutes of Health in Bethesda, Maryland, in a press release.2

You may also like...

Malignancy in Patients With Psoriasis: Understanding Risk and Appropriate Management

Does Psoriasis Increase the Risk of Sexual Dysfunction?
Risk of Malignancy Comparable Between Biologics
In the prospective observational study, first author Youssef Elnabawi, MD, and colleagues at the National Heart, Lung, and Blood Institute recruited 121 participants with psoriasis who had not been treated with biologics at baseline. Mean age of participants was 50.2 years, over half of the participants were male (n=70) with low cardiovascular risk based on the Framingham score, and participants had moderate to severe skin disease at baseline. Total coronary plaque burden and plaque subcomponents (calcified and non-calcified) in the 3 main coronary vessels were assessed by a blinded reviewer.


Elnabawi et al found treatment with a biologic was associated with a 6% reduction in non-calcified plaque burden and reduction in necrotic core, with no effect on fibrous burden.


In comparisons between plaque characteristic changes over 1 year, Elnabawi et al observed that decreases in non-calcified plaque burden associated with biologic treatment were significant compared with slow plaque progression among those not treated with biologics, and were associated with biologic therapy after adjusting for traditional cardiovascular risk factors.


“We found that these anti-inflammatory drugs commonly used to treat severe psoriasis also improve plaque in the coronary artery making them more stable and less likely to cause a heart attack,” said Dr Mehta. “This occurred in the absence of changes in traditional cardiovascular risk factors including blood pressure and blood lipids.”2


“This preliminary study provides the first evidence that biologic therapy is associated with coronary plaque reduction and stabilization and provides strong rationale for conduct of a randomized trial testing the impact of biologic therapy on the progression of coronary disease in patients with psoriasis,” Dr Mehta added.




1. Elnabawi YA, Dey AK, Goyal A, et al. Coronary artery plaque characteristics and treatment with biologic therapy in severe psoriasis: Results from a prospective observational study [published online February 5, 2019]. Cardiovasc Res. doi:10.1093/cvr/cvz009.


2. Psoriasis medication may improve heart disease in patients with the skin condition [press release]. Sophia Antipolis, France: European Society of Cardiology; February 5, 2019. Accessed February 6, 2019.