nach oben

American Journal of Clinical Dermatology

Erschienen in:

01.02.2013 | Leading Article

Risk of Cardiovascular Disorders in Psoriasis Patients

Current and Future

verfasst von: Ingrid L. D. Tablazon, Amir Al-Dabagh, Scott A. Davis, Steven R. Feldman

Erschienen in: American Journal of Clinical Dermatology | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

Psoriasis is an inflammatory autoimmune disease that affects the skin. Recently, psoriasis and its consequential lifestyle and dietary habits have been associated with increased risks for cardiovascular diseases. This article discusses the connection between cardiovascular disorders and psoriasis and the effects of available treatment options on cardiovascular risk. A PubMed search revealed 11 articles that were analyzed for information regarding this association, its effects, and potential courses of treatment. Both the presence and severity of psoriasis increases the risk for cardiovascular disorders and co-morbidities. Forty percent of psoriasis patients met metabolic syndrome criteria as compared with 23 % of non-psoriasis control subjects. Rate ratios for atrial fibrillation are correlated with the severity of psoriasis; patients with severe and mild psoriasis produced rate ratios of 1.63 and 1.31, respectively. Studies also show an increase in the risks for myocardial infarction, atherosclerosis, ischemic stroke, and other cardiovascular disorders. The exact mechanisms behind this affiliation are still uncertain; however, the psychological and physiological effects of psoriasis and the overlapping pathogenesis behind atherosclerosis and psoriasis may play a role. Since the risk for cardiovascular disorders increases with the presence and severity of psoriasis, psoriasis treatment should not only address the disease and its symptoms, but also its co-morbidities. Recent National Psoriasis Foundation (NPF) guidelines have provided recommendations for psoriasis patient care. Histories of co-morbidities, screenings for potential diseases, increased exercise, decreased alcohol consumption, and smoking cessation should be implemented. Unfortunately, while there are data for the increased risk for cardiovascular diseases within psoriasis patients, there are presently no data stating that increasing cardiovascular screening rates in patients produces a significant difference.

Fernandez-Torres R, Pita-Fernandez S, Fonseca E. Psoriasis and cardiovascular risk: assessment by different cardiovascular risk scores. J Eur Acad Dermatol Venereol. 2012. [Epub ahead of print].

Mercuri SR, Naldi L. Potential role of ustekinumab in the treatment of chronic plaque psoriasis. Biologics. 2010;4:119–29.PubMed

Naldi L, Mercuri SR. Epidemiology of comorbidities in psoriasis. Dermatol Ther. 2010;23(2):114–8.PubMedCrossRef

Horn EJ, Fox KM, Patel V, et al. Are patients with psoriasis undertreated? Results of National psoriasis foundation survey. J Am Acad Dermatol. 2007;57(6):957–62.PubMedCrossRef

Love TJ, Qureshi AA, Karlson EW, et al. Prevalence of the metabolic syndrome in psoriasis: results from the National health and nutrition examination survey, 2003–2006. Arch Dermatol. 2011;147(4):419–24.PubMedCrossRef

Prodanovich S, Kirsner RS, Kravetz JD, et al. Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol. 2009;145(6):700–3.PubMedCrossRef

Gisondi P, Farina S, Giordano MV, et al. Usefulness of the Framingham risk score in patients with chronic psoriasis. Am J Cardiol. 2010;106(12):1754–7.PubMedCrossRef

Jensen P, Thyssen JP, Zachariae C, et al. Cardiovascular risk factors in subjects with psoriasis: a cross-sectional general population study. Int J Dermatol. 2012. [Epub ahead of print].

Ahlehoff O, Gislason GH, Jorgensen CH, et al. Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish nationwide cohort study. Eur Heart J. 2012;33(16):2054–64.PubMedCrossRef

10.

Kremers HM, McEvoy MT, Dann FJ, et al. Heart disease in psoriasis. J Am Acad Dermatol. 2007;57(2):347–54.PubMedCrossRef

11.

Zhang K, Li X, Yin G, et al. Functional characterization of T cells differentiated in vitro from bone marrow-derived CD34 cells of psoriatic patients with family history. Exp Dermatol. 2010;19(8):e128–35.PubMedCrossRef

12.

Libby P. The molecular mechanisms of the thrombotic complications of atherosclerosis. J Intern Med. 2008;263(5):517–27.PubMedCrossRef

13.

Miossec P. IL-17 and Th17 cells in human inflammatory diseases. Microbes Infect. 2009;11(5):625–30.PubMedCrossRef

14.

Eid RE, Rao DA, Zhou J, et al. Interleukin-17 and interferon-gamma are produced concomitantly by human coronary artery-infiltrating T cells and act synergistically on vascular smooth muscle cells. Circulation. 2009;119(10):1424–32.PubMedCrossRef

15.

Cheng X, Yu X, Ding YJ, et al. The Th17/Treg imbalance in patients with acute coronary syndrome. Clin Immunol. 2008;127(1):89–97.PubMedCrossRef

16.

Kagen MH, McCormick TS, Cooper KD. Regulatory T cells in psoriasis. Ernst Schering Res Found Workshop. 2006;56:193–209.PubMedCrossRef

17.

Mor A, Luboshits G, Planer D, et al. Altered status of CD4(+)CD25(+) regulatory T cells in patients with acute coronary syndromes. Eur Heart J. 2006;27(21):2530–7.PubMedCrossRef

18.

Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med. 2009;361(5):496–509.PubMedCrossRef

19.

Tonel G, Conrad C. Interplay between keratinocytes and immune cells: recent insights into psoriasis pathogenesis. Int J Biochem Cell Biol. 2009;41(5):963–8.PubMedCrossRef

20.

Pietrzak AT, Zalewska A, Chodorowska G, et al. Cytokines and anticytokines in psoriasis. Clin Chim Acta. 2008;394(1–2):7–21.PubMedCrossRef

21.

Csiszar A, Ungvari Z. Synergistic effects of vascular IL-17 and TNFalpha may promote coronary artery disease. Med Hypotheses. 2004;63(4):696–8.PubMedCrossRef

22.

Armstrong AW, Voyles SV, Armstrong EJ, et al. A tale of two plaques: convergent mechanisms of T-cell-mediated inflammation in psoriasis and atherosclerosis. Exp Dermatol. 2011;20(7):544–9.PubMedCrossRef

23.

Engelmann MD, Svendsen JH. Inflammation in the genesis and perpetuation of atrial fibrillation. Eur Heart J. 2005;26(20):2083–92.PubMedCrossRef

24.

McDonald I, Connolly M, Tobin AM. A review of psoriasis, a known risk factor for cardiovascular disease and its impact on folate and homocysteine metabolism. J Nutr Metab. 2012. [Epub ahead of print].

25.

Graham IM, Daly LE, Refsum HM, et al. Plasma homocysteine as a risk factor for vascular disease: the European concerted action project. JAMA. 1997;277(22):1775–81.PubMedCrossRef

26.

Ahdout J, Kotlerman J, Elashoff D, et al. Modifiable lifestyle factors associated with metabolic syndrome in patients with psoriasis. Clin Exp Dermatol. 2012;37(5):477–83.PubMedCrossRef

27.

Gans KM, Risica PM, Wylie-Rosett J, et al. Development and evaluation of the nutrition component of the rapid eating and activity assessment for patients (REAP): a new tool for primary care providers. J Nutr Educ Behav. 2006;38(5):286–92.PubMedCrossRef

28.

Fortune DG, Richards HL, Griffiths CE. Psychologic factors in psoriasis: consequences, mechanisms, and interventions. Dermatol Clin. 2005;23(4):681–94.PubMedCrossRef

29.

Kimball AB, Gladman D, Gelfand JM, et al. National psoriasis foundation clinical consensus on psoriasis comorbidities and recommendations for screening. J Am Acad Dermatol. 2008;58(6):1031–42.PubMedCrossRef

30.

Gelfand JM, Mehta NN, Langan SM. Psoriasis and cardiovascular risk: strength in numbers, part II. J Invest Dermatol. 2011;131(5):1007–10.PubMedCrossRef

31.

Prodanovich S, Ma F, Taylor JR, et al. Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol. 2005;52(2):262–7.PubMedCrossRef

32.

Abuabara K, Lee H, Kimball AB. The effect of systemic psoriasis therapies on the incidence of myocardial infarction: a cohort study. Br J Dermatol. 2011;165(5):1066–73.PubMedCrossRef

33.

Boehncke WH, Boehncke S, Schon MP. Managing comorbid disease in patients with psoriasis. BMJ. 2010;340:b5666. doi:10.1136/bmj.b5666.:b5666.PubMedCrossRef

34.

Waisman A. To be 17 again: anti-interleukin-17 treatment for psoriasis. N Engl J Med. 2012;366(13):1251–2.PubMedCrossRef

35.

Cingoz O. Ustekinumab. MAbs. 2009;1(3):216–21.PubMedCrossRef

36.

Nair RP, Ruether A, Stuart PE, et al. Polymorphisms of the IL12B and IL23R genes are associated with psoriasis. J Invest Dermatol. 2008;128(7):1653–61.PubMedCrossRef

37.

Leonardi CL, Kimball AB, Papp KA, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet. 2008;371(9625):1665–74.PubMedCrossRef

38.

Ionescu MA, Lipozencic J. Could anti IL12/23 therapy replace anti-TNF biologics? Acta Dermatovenerol Croat. 2009;17(3):166–9.PubMed

39.

Shaker OG, Moustafa W, Essmat S, et al. The role of interleukin-12 in the pathogenesis of psoriasis. Clin Biochem. 2006;39(2):119–25.PubMedCrossRef

40.

Gudjonsson JE, Elder JT. Psoriasis. In: Goldsmith LA, Katz SI, Wolff K, et al., editors. Fitzpatrick’s dermatology in general medicine. New York: McGraw Hill; 2008. p. 169–74.

41.

Reddy M, Davis C, Wong J, et al. Modulation of CLA, IL-12R, CD40L, and IL-2Ralpha expression and inhibition of IL-12- and IL-23-induced cytokine secretion by CNTO 1275. Cell Immunol. 2007;247(1):1–11.PubMedCrossRef

42.

Krueger GG, Langley RG, Leonardi C, et al. A human interleukin-12/23 monoclonal antibody for the treatment of psoriasis. N Engl J Med. 2007;356(6):580–92.PubMedCrossRef

43.

Papp KA, Langley RG, Lebwohl M, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371(9625):1675–84.PubMedCrossRef

44.

Kimball AB, Gordon KB, Langley RG, et al. Safety and efficacy of ABT-874, a fully human interleukin 12/23 monoclonal antibody, in the treatment of moderate to severe chronic plaque psoriasis: results of a randomized, placebo-controlled, phase 2 trial. Arch Dermatol. 2008;144(2):200–7.PubMedCrossRef

45.

Reich K, Langley RG, Lebwohl M, et al. Cardiovascular safety of ustekinumab in patients with moderate to severe psoriasis: results of integrated analyses of data from phase II and III clinical studies. Br J Dermatol. 2011;164(4):862–72.PubMedCrossRef

46.

Ryan C, Leonardi CL, Krueger JG, et al. Association between biologic therapies for chronic plaque psoriasis and cardiovascular events: a meta-analysis of randomized controlled trials. JAMA. 2011;306(8):864–71.PubMedCrossRef

47.

Tsai TF, Ho JC, Song M, et al. Efficacy and safety of ustekinumab for the treatment of moderate-to-severe psoriasis: a phase III, randomized, placebo-controlled trial in Taiwanese and Korean patients (PEARL). J Dermatol Sci. 2011;63(3):154–63.PubMedCrossRef

48.

Reich K, Papp KA, Griffiths CE, et al. An update on the long-term safety experience of ustekinumab: results from the psoriasis clinical development program with up to four years of follow-up. J Drugs Dermatol. 2012;11(3):300–12.PubMed

49.

Tzellos T, Kyrgidis A, Zouboulis CC. Re-evaluation of the risk for major adverse cardiovascular events in patients treated with anti-IL-12/23 biological agents for chronic plaque psoriasis: a meta-analysis of randomized controlled trials. J Eur Acad Dermatol Venereol. 2012. [Epub ahead of print].

50.

Roark CL, Simonian PL, Fontenot AP, et al. Gammadelta T cells: an important source of IL-17. Curr Opin Immunol. 2008;20(3):353–7.PubMedCrossRef

51.

Reich K. Anti-interleukin-17 monoclonal antibody ixekizumab in psoriasis (letter). N Engl J Med. 2012;367(3):274.PubMedCrossRef

52.

Papp KA, Leonardi C, Menter A, et al. Brodalumab, an anti-interleukin-17-receptor antibody for psoriasis. N Engl J Med. 2012;366(13):1181–9.PubMedCrossRef

53.

Leonardi C, Matheson R, Zachariae C, et al. Anti-interleukin-17 monoclonal antibody ixekizumab in chronic plaque psoriasis. N Engl J Med. 2012;366(13):1190–9.PubMedCrossRef

54.

Feldman SR, Ravis S, Moran WP, et al. Patients seen in a dermatology clinic have unmet preventive health care needs. J Am Acad Dermatol. 2001;44(4):706–9.PubMedCrossRef

55.

Fenerty SD, West C, Davis SA, et al. The effect of reminder systems on patients’ adherence to treatment. Patient Prefer Adherence. 2012;6:127–35.PubMed

56.

Feldman SR, Horn EJ, Balkrishnan R, et al. Psoriasis: improving adherence to topical therapy. J Am Acad Dermatol. 2008;59(6):1009–16.PubMedCrossRef

57.

Martin SL, McGoey ST, Bebo Jr BF, et al. Patients’ educational needs about topical treatments for psoriasis. J Am Acad Dermatol. 2012. [Epub ahead of print].

Titel: Risk of Cardiovascular Disorders in Psoriasis Patients
Current and Future
verfasst von: Ingrid L. D. Tablazon
Amir Al-Dabagh
Scott A. Davis
Steven R. Feldman
Publikationsdatum: 01.02.2013
Verlag: Springer International Publishing AG
Erschienen in: American Journal of Clinical Dermatology / Ausgabe 1/2013
Print ISSN: 1175-0561
Elektronische ISSN: 1179-1888
DOI: https://doi.org/10.1007/s40257-012-0005-5

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Dermatologie

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

16.04.2024 DGIM 2024 Nachrichten

Den Reflex, eine oberflächliche chronische Hautwunde ohne Entzündungszeichen in jedem Fall abzustreichen, sollte man nach einer neuen „Klug-entscheiden“-Empfehlung unterdrücken.

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2013

Vemurafenib

Depigmentation Patterns of Nonsegmental Vitiligo

Combination Therapy in Psoriasis

Vismodegib

Principal Determinants of the Length of Remission of Psoriasis Vulgaris After Topical, NB-UVB, and PUVA Therapy