This observational study is the first known of its kind to successfully demonstrate treating remote inflammation in the body could modulate coronary disease. Study findings were presented at the 2018 Society for Cardiovascular Angiography and Interventions Scientific Sessions.
Approximately 150,000 new cases of psoriasis are diagnosed within USA each year, the disease affects upwards of 7.5 million people. Evidence has demonstrated decreases in adverse cardiovascular events targeting cytokine interleukin-1 beta.
Researchers were investigating whether treatment of inflammatory skin disease could affect coronary plaque. Typically TNF agents are used, biological, and FDA approved immunomodulatory treatments for psoriasis. Over 80 patients were consecutively stratified by biological treatment and non-biological treatment. Plaque volume, non-calcified burden, and maximal artery stenosis in proximal vessels were blindly assessed based upon coronary CT angiography using dedicated software. Participants were middle aged and at low risk of cardiovascular disease.
At the one year marker plaque volume in the biological treated group had reduced by 40%. Non-calcified burden and maximal stenosis groups were significant and consistent with plaque volume. Change in plaque volume was associated positively with a IL1B change even after making adjustments to take into account statin use and traditional cardiovascular risk factors.
Researchers say that a change in coronary plaque after just one year using biological therapy in very assuring, especially since this is the first time to see skin disease treatment having impact on coronary plaque. Results highlight importance of patients maintaining psoriasis treatment to reduces the risk of adverse cardiovascular events, and opens new paths to look at disease states to investigate how anti-inflammatory therapy options may affect coronary plaque.
It was noted that additional randomized studies are needed to confirm observational findings, to gain better understandings of how treatment with anti-inflammatory medications over time modulate plaque volume.