Do TNF Inhibitors Offer CV Benefits in Psoriasis, Psoriatic Arthritis?

Net clinical benefits were seen with TNF inhibitors
Net clinical benefits were seen with TNF inhibitors

In a study published in Clinical Reviews in Allergy & Immunology, researchers found that tumor necrosis factor (TNF) inhibitors appeared to have clinical benefits with regard to adverse cardiovascular events in psoriasis and/or psoriatic arthritis. 

Psoriasis and psoriatic arthritis have been associated with higher risk of cardiac and cerebrovascular events but whether TNF inhibitors have an effect on reducing cardiovascular events remains unclear. Zheng-sheng Yang, from The First Hospital of Qinhuangdao, China, and colleagues evaluated the effect of TNF inhibitors on adverse cardiovascular events in psoriasis with or without psoriatic arthritis by conducting a meta-analysis of clinical trials. They searched various databases through December 31, 2015 and included a total of 5 studies (n=49,795) for their analysis. 

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The authors found that TNF inhibitors were associated with a significantly lower risk of cardiovascular events (risk ratio [RR] 0.58, 95% CI: 0.43–0.77; P<0.001) vs. topical/photo treatment. When compared with methotrexate, the risk of cardiovascular events was also notably lower in the TNF inhibitor group (RR 0.67, 95% CI: 0.52–0.88; P=0.003). TNF inhibitors were also associated with a decreased incidence of myocardial infarction vs. topical/photo or methotrexate treatment (RR 0.73, 95% CI: 0.59–0.90; P=0.003 and RR 0.65, 95% CI: 0.48–0.89; P=0.007, respectively). The TNF inhibitor group also showed a lower rate of mortality vs. other therapy (RR 0.90, 95% CI: 0.54–1.50; P=0.68). 

Overall, TNF inhibitors appeared to have net clinical benefits with regard to adverse cardiovascular events in psoriasis and/or psoriatic arthritis. Further randomized controlled trials are necessary to assess whether TNF inhibitors lead to a reduction in cardiovascular diseases. 

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