Treatment of psoriasis with injections may compensate for the higher risk of patients with heart disease, the study finds
Treatment of psoriasis with injection drugs can reduce inflammation in the vital arteries that feed the heart, a study published Wednesday suggests.
Psoriasis, such as lupus and rheumatoid arthritis, is an inflammatory autoimmune disease that is afflicted by millions of Americans, including model Cara Delevigne and Kim Kardashian West, who has been diagnosed with the condition since her diagnosis in 2011.
The inflammation that leads to the red and scaly patches of the skin condition also increases the risk of developing heart disease by causing the coronary arteries to contract.
So scientists from the National Institutes of Health (NIH) have conducted experiments to see if treatment for psoriasis could also treat coronary inflammation.
Remarkably, they discovered that the treatment worked – for both psoriasis and coronary inflammation, suggesting a new way to counter the dangerous effects of inflammatory diseases on the cardiovascular system.
Biologists are powerful immunosuppressive injection drugs used to treat moderate to severe psoriasis (see photo), but new research is also combating autoimmune disease systemic inflammation to reduce fat deposits around blood vessels that feed the heart.
About three to five percent of Americans develop psoriasis, which increases their risk of heart disease, the largest killer in the US.
A Danish study has even shown that people with severe psoriasis have a 54 percent higher risk of stroke, a 21 percent higher risk of a heart attack and are 53 percent more likely to die over a 10-year period.
These risks underline the fact that psoriasis is much more than a cosmetic problem.
The full causes and pathology of psoriasis are not understood, but scientists believe it occurs when infection-fighting T cells mistakenly attack healthy skin cells.
This bombardment leads to an overproduction of skin cells that accumulate in pests or spots and redness or inflammation, a characteristic of the counterattack of an immune system to infections.
The body demands overreactivity of the immune system.
Inflammation can cause blood vessels to harden and narrow.
And that is especially dangerous for the blood vessels that carry blood to the heart.
Psoriasis is a chronic condition, but can be treated with retinoid or steroid topical creams, light therapy or medication, including a class called biological.
Biologics are powerful drugs that change the immune system to weaken its excessive responses.
They are usually only used as a last resort, because suppressing the immune system makes people more vulnerable to life-threatening infections.
To test their effects on coronary arteries, the researchers recruited 134 patients with moderate to severe psoriasis who had not been treated with biological treatment for at least three months.
Participants were given the choice: try biological injections or undergo light or topical therapies and be part of the control group.
Of these, 82 decided to try biology.
The researchers from the National Heart, Lung and Blood Institute (NHLBI) used CT scans to peer into the blood vessels of the participants at the start and during the study.
CT imaging shows a high fat plaque in the patient's blood vessel at the start of the study (left, shown in red) and the dramatic reduction one year after the first biological treatment (right)
Everyone had a low risk of cardiovascular disease when they joined the study, but some already had a significant build-up of the fat-like plaques in the linings around their arteries, according to their first scans.
These fat deposits are predictive of heart attacks, strokes and heart failure, life-threatening cardiovascular events that occur between six and nine times more often in people who score high on a blood vessel fat scale.
But a year later, everyone who had received the biological treatment – including those whose arteries were already fat – had clear improvements.
Much less of this so-called perivascular fat was visible in their second scans.
& # 39; An important question was whether we could adjust it with anti-inflammatory interventions, & # 39; said Dr. Nehal Mehta, a cardiologist and head of the Lab of Inflammation and Cardiometabolic Diseases at NHLB.
& # 39; As far as we know, our study is the first to assess the potential effects of biological therapy on coronary inflammation using the measure (of perivascular fat). & # 39;
At least one NIH study, published in February, has also indicated that biological benefits can be obtained for blood vessels.
The authors of the study hope that these injections can help neutralize the risk of heart disease, not only for psoriasis patients, but also for people with other inflammatory autoimmune diseases such as lupus and rheumatoid arthritis.
Systemic inflammation – often due to these disorders – places between 20 and 30 percent of Americans at an increased risk of heart disease-related catastrophic health problems.
& # 39; Our findings contribute to the growing number of studies showing that treatment of underlying inflammatory conditions can reduce the risk of cardiovascular disease, & # 39; said Dr. Mehta.
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