Patients with psoriasis being treated with tumor necrosis factor(TNF)-alpha inhibitors are not at greater risk for cardiovascular disease, suggested the results of a review article in The Permanente Journal.
To study the relationship between TNF-alpha inhibitors and cardiovascular disease in psoriasis, Thao Nguyen, MD, of Los Angeles Medical Center, reviewed 22 randomized controlled trials, which included 10,183 patients. The trials evaluated a possible association between biologic therapies for chronic plaque psoriasis and major adverse cardiac events.
The studies included in the review examined monotherapy of anti-interleukin(IL)-12/23 agents ustekinumab (Stelara) and briakinumab (withdrawn from the US and European markets in 2011) and anti-TNF-alpha agents adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade).
During the placebo-controlled phases of the anti-IL-12/23 studies, 10 of the 3,179 patients treated with these therapies had a major adverse cardiac event compared with zero events in the 1,474 patients treated with placebo. In studies of patients taking anti-TNF-alpha agents, one of the 3,858 patients had a major adverse cardiac event compared with one of the 1,812 treated with placebo.
“This meta-analysis did not show a significant increase in the risk of major adverse cardiac events associated with the use of anti-IL-12/23 agents or anti-TNF-alpha agents,” wrote the researchers.
While some trials indicated no elevated risk of major adverse cardiac events, the results reflect that an increase in the use of TNF-alpha inhibitors may decrease the risk of major adverse cardiac events.
“As more patients receiving TNF-alpha inhibitor therapy are enrolled in postmarketing registries, more long-term data will help elucidate whether these agents may benefit the risk reduction for major adverse cardiac events,” concluded the researchers.
One author reports receiving research funding from AbbVie Inc., Amgen Inc. and Pfizer Inc.