Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis: Results of a pilot study

Hajnalka Jókai, József Szakonyi, Orsolya Kontár, Márta Marschalkó, Klára Szalai, S. Kárpáti, Péter Holló

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background Psoriasis is associated with higher incidence of atherosclerotic comorbidities. Sustained arterial wall inflammation mediated by common cytokines of psoriasis and atherogenesis precedes atherosclerotic plaque development. Increased intima-media thickness (IMT) is an accepted indicator of subclinical atherosclerosis and has been reported in severe psoriasis. Objective This pilot study aimed to clarify whether effective long-term tumor necrosis factor-alfa inhibition decreases IMT in psoriasis. Methods In 16 patients with severe psoriasis, the Psoriasis Area and Severity Index score was calculated before therapy (etanercept, infliximab, adalimumab) and after 6-month treatment. Simultaneously, carotid and brachial IMT was measured by high-resolution, B-mode ultrasonography. Difference between initial and 6-month IMT values was determined for monitored arteries collectively and separately in carotid and brachial arteries. Results All of 16 patients achieved Psoriasis Area and Severity Index 75, and 14 of 16 achieved Psoriasis Area and Severity Index 90 improvement. In the group of patients without initial calcified atherosclerotic plaques (13 of 16) significant IMT decrease was detected when arteries were measured collectively (P =.0002). Initial and follow-up data differed significantly also at individual analysis of carotid (P =.011) and brachial (P =.006) arteries. Eleven of 13 patients had initial carotid IMT exceeding age-adjusted normal values. The other group (3 of 16) with initial manifest plaques showed increasing IMT tendency. Their baseline ultrasonography revealed carotid IMT above the upper limit of healthy adults' age-adjusted values. Limitations Study limitation involves small patient numbers, self-controlled study design, and lack of patients' stratification according to common cardiovascular risk factors. Conclusion In our pilot study effective tumor necrosis factor-alfa inhibition was found to decrease IMT in psoriatic patients without irreversible atherosclerotic plaques. Further analysis is recommended to confirm and complete our primary observations.

Original languageEnglish
Pages (from-to)523-529
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume69
Issue number4
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Tunica Intima
Tunica Media
Psoriasis
Tumor Necrosis Factor-alpha
Carotid Intima-Media Thickness
Atherosclerotic Plaques
Arteries
Therapeutics
Ultrasonography
Atherosclerosis
Arm
Arteritis
Brachial Artery
Carotid Arteries
Comorbidity
Reference Values
Cytokines

Keywords

  • arterial intima-media thickness
  • atherosclerosis
  • cardiovascular risk
  • high-resolution B-mode ultrasonography
  • psoriasis vulgaris
  • tumor necrosis factor-alfa inhibitor

ASJC Scopus subject areas

  • Dermatology

Cite this

Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis : Results of a pilot study. / Jókai, Hajnalka; Szakonyi, József; Kontár, Orsolya; Marschalkó, Márta; Szalai, Klára; Kárpáti, S.; Holló, Péter.

In: Journal of the American Academy of Dermatology, Vol. 69, No. 4, 10.2013, p. 523-529.

Research output: Contribution to journalArticle

Jókai, Hajnalka ; Szakonyi, József ; Kontár, Orsolya ; Marschalkó, Márta ; Szalai, Klára ; Kárpáti, S. ; Holló, Péter. / Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis : Results of a pilot study. In: Journal of the American Academy of Dermatology. 2013 ; Vol. 69, No. 4. pp. 523-529.
@article{59cd07662f2842cd86fb0c6b42c89504,
title = "Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis: Results of a pilot study",
abstract = "Background Psoriasis is associated with higher incidence of atherosclerotic comorbidities. Sustained arterial wall inflammation mediated by common cytokines of psoriasis and atherogenesis precedes atherosclerotic plaque development. Increased intima-media thickness (IMT) is an accepted indicator of subclinical atherosclerosis and has been reported in severe psoriasis. Objective This pilot study aimed to clarify whether effective long-term tumor necrosis factor-alfa inhibition decreases IMT in psoriasis. Methods In 16 patients with severe psoriasis, the Psoriasis Area and Severity Index score was calculated before therapy (etanercept, infliximab, adalimumab) and after 6-month treatment. Simultaneously, carotid and brachial IMT was measured by high-resolution, B-mode ultrasonography. Difference between initial and 6-month IMT values was determined for monitored arteries collectively and separately in carotid and brachial arteries. Results All of 16 patients achieved Psoriasis Area and Severity Index 75, and 14 of 16 achieved Psoriasis Area and Severity Index 90 improvement. In the group of patients without initial calcified atherosclerotic plaques (13 of 16) significant IMT decrease was detected when arteries were measured collectively (P =.0002). Initial and follow-up data differed significantly also at individual analysis of carotid (P =.011) and brachial (P =.006) arteries. Eleven of 13 patients had initial carotid IMT exceeding age-adjusted normal values. The other group (3 of 16) with initial manifest plaques showed increasing IMT tendency. Their baseline ultrasonography revealed carotid IMT above the upper limit of healthy adults' age-adjusted values. Limitations Study limitation involves small patient numbers, self-controlled study design, and lack of patients' stratification according to common cardiovascular risk factors. Conclusion In our pilot study effective tumor necrosis factor-alfa inhibition was found to decrease IMT in psoriatic patients without irreversible atherosclerotic plaques. Further analysis is recommended to confirm and complete our primary observations.",
keywords = "arterial intima-media thickness, atherosclerosis, cardiovascular risk, high-resolution B-mode ultrasonography, psoriasis vulgaris, tumor necrosis factor-alfa inhibitor",
author = "Hajnalka J{\'o}kai and J{\'o}zsef Szakonyi and Orsolya Kont{\'a}r and M{\'a}rta Marschalk{\'o} and Kl{\'a}ra Szalai and S. K{\'a}rp{\'a}ti and P{\'e}ter Holl{\'o}",
year = "2013",
month = "10",
doi = "10.1016/j.jaad.2013.06.019",
language = "English",
volume = "69",
pages = "523--529",
journal = "Journal of the American Academy of Dermatology",
issn = "0190-9622",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis

T2 - Results of a pilot study

AU - Jókai, Hajnalka

AU - Szakonyi, József

AU - Kontár, Orsolya

AU - Marschalkó, Márta

AU - Szalai, Klára

AU - Kárpáti, S.

AU - Holló, Péter

PY - 2013/10

Y1 - 2013/10

N2 - Background Psoriasis is associated with higher incidence of atherosclerotic comorbidities. Sustained arterial wall inflammation mediated by common cytokines of psoriasis and atherogenesis precedes atherosclerotic plaque development. Increased intima-media thickness (IMT) is an accepted indicator of subclinical atherosclerosis and has been reported in severe psoriasis. Objective This pilot study aimed to clarify whether effective long-term tumor necrosis factor-alfa inhibition decreases IMT in psoriasis. Methods In 16 patients with severe psoriasis, the Psoriasis Area and Severity Index score was calculated before therapy (etanercept, infliximab, adalimumab) and after 6-month treatment. Simultaneously, carotid and brachial IMT was measured by high-resolution, B-mode ultrasonography. Difference between initial and 6-month IMT values was determined for monitored arteries collectively and separately in carotid and brachial arteries. Results All of 16 patients achieved Psoriasis Area and Severity Index 75, and 14 of 16 achieved Psoriasis Area and Severity Index 90 improvement. In the group of patients without initial calcified atherosclerotic plaques (13 of 16) significant IMT decrease was detected when arteries were measured collectively (P =.0002). Initial and follow-up data differed significantly also at individual analysis of carotid (P =.011) and brachial (P =.006) arteries. Eleven of 13 patients had initial carotid IMT exceeding age-adjusted normal values. The other group (3 of 16) with initial manifest plaques showed increasing IMT tendency. Their baseline ultrasonography revealed carotid IMT above the upper limit of healthy adults' age-adjusted values. Limitations Study limitation involves small patient numbers, self-controlled study design, and lack of patients' stratification according to common cardiovascular risk factors. Conclusion In our pilot study effective tumor necrosis factor-alfa inhibition was found to decrease IMT in psoriatic patients without irreversible atherosclerotic plaques. Further analysis is recommended to confirm and complete our primary observations.

AB - Background Psoriasis is associated with higher incidence of atherosclerotic comorbidities. Sustained arterial wall inflammation mediated by common cytokines of psoriasis and atherogenesis precedes atherosclerotic plaque development. Increased intima-media thickness (IMT) is an accepted indicator of subclinical atherosclerosis and has been reported in severe psoriasis. Objective This pilot study aimed to clarify whether effective long-term tumor necrosis factor-alfa inhibition decreases IMT in psoriasis. Methods In 16 patients with severe psoriasis, the Psoriasis Area and Severity Index score was calculated before therapy (etanercept, infliximab, adalimumab) and after 6-month treatment. Simultaneously, carotid and brachial IMT was measured by high-resolution, B-mode ultrasonography. Difference between initial and 6-month IMT values was determined for monitored arteries collectively and separately in carotid and brachial arteries. Results All of 16 patients achieved Psoriasis Area and Severity Index 75, and 14 of 16 achieved Psoriasis Area and Severity Index 90 improvement. In the group of patients without initial calcified atherosclerotic plaques (13 of 16) significant IMT decrease was detected when arteries were measured collectively (P =.0002). Initial and follow-up data differed significantly also at individual analysis of carotid (P =.011) and brachial (P =.006) arteries. Eleven of 13 patients had initial carotid IMT exceeding age-adjusted normal values. The other group (3 of 16) with initial manifest plaques showed increasing IMT tendency. Their baseline ultrasonography revealed carotid IMT above the upper limit of healthy adults' age-adjusted values. Limitations Study limitation involves small patient numbers, self-controlled study design, and lack of patients' stratification according to common cardiovascular risk factors. Conclusion In our pilot study effective tumor necrosis factor-alfa inhibition was found to decrease IMT in psoriatic patients without irreversible atherosclerotic plaques. Further analysis is recommended to confirm and complete our primary observations.

KW - arterial intima-media thickness

KW - atherosclerosis

KW - cardiovascular risk

KW - high-resolution B-mode ultrasonography

KW - psoriasis vulgaris

KW - tumor necrosis factor-alfa inhibitor

UR - http://www.scopus.com/inward/record.url?scp=84884357683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884357683&partnerID=8YFLogxK

U2 - 10.1016/j.jaad.2013.06.019

DO - 10.1016/j.jaad.2013.06.019

M3 - Article

C2 - 23891393

AN - SCOPUS:84884357683

VL - 69

SP - 523

EP - 529

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

SN - 0190-9622

IS - 4

ER -