Document Detail


Effective continuous systemic therapy of severe plaque-type psoriasis is accompanied by amelioration of biomarkers of cardiovascular risk: results of a prospective longitudinal observational study.
MedLine Citation:
PMID:  21241371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Severe psoriasis is associated with significant cardiovascular mortality.
OBJECTIVES: We investigated the effects of continuous systemic therapy on the cardiovascular risk of patients with severe plaque-type psoriasis.
METHODS: A total of 42 consecutive patients receiving systemic treatment for their severe plaque-type psoriasis were included. The clinical course was monitored over 24 weeks. Initially as well as after 12 and 24 weeks, oral glucose tolerance tests were performed along with comprehensive laboratory monitoring.
RESULTS: Responding patients, defined as a Psoriasis Area and Severity Index (PASI)-50 response, showed correlations between the PASI and high-sensitive C-reactive protein (r = 0.45, P = 0.03) as well as with vascular endothelial growth factor (r = 0.76, P = 0.007). The adipokine resistin was positively and the potentially cardio-protective adiponectin was negatively correlated with the PASI (r = 0.50, P = 0.02 and r = -0.56, P = 0.007, respectively). Oral glucose tolerance tests yielded a correlation between the PASI and plasma levels for C-peptide (r = 0.73, P = 0.02) at t = 120 min in patients with a pathological Homeostasis Model Assessment (>2.5), indicating that the state of peripheral insulin resistance is driven at least in part by the severity of the psoriatic inflammation. Correlations between the change of adipokine levels and change in PASI were more pronounced among patients with better clinical improvement (PASI-75 vs. PASI-50).
CONCLUSIONS: We document an amelioration of biomarkers of cardiovascular risk in patients with severe plaque-type psoriasis responding to continuous systemic therapy. The impact on the patients'metabolic state was found to be better if the psoriatic inflammation was controlled for longer. Future studies need to compare the cardioprotective effects of different treatment modalities, based on hard clinical endpoints.
Authors:
S Boehncke; R Salgo; J Garbaraviciene; H Beschmann; K Hardt; S Diehl; S Fichtlscherer; D Thaçi; W-H Boehncke
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-01-17
Journal Detail:
Title:  Journal of the European Academy of Dermatology and Venereology : JEADV     Volume:  25     ISSN:  1468-3083     ISO Abbreviation:  J Eur Acad Dermatol Venereol     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-19     Completed Date:  2012-03-22     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9216037     Medline TA:  J Eur Acad Dermatol Venereol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1187-93     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.
Affiliation:
Department of Internal Medicine, Section for Diabetes, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. boehncke@em.uni-frankfurt.de
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MeSH Terms
Descriptor/Qualifier:
Adipokines / blood
Adult
Aged
Antibodies, Monoclonal, Humanized / therapeutic use
Biological Markers / blood
C-Reactive Protein / metabolism*
Cardiovascular Diseases / blood,  epidemiology*
Cyclosporine / therapeutic use
Female
Fumarates / therapeutic use
Humans
Immunoglobulin G / therapeutic use
Longitudinal Studies
Male
Methotrexate / therapeutic use
Middle Aged
Prospective Studies
Psoriasis / blood*,  drug therapy*
Receptors, Tumor Necrosis Factor / therapeutic use
Resistin / blood*
Risk Factors
Severity of Illness Index*
Treatment Outcome
Vascular Endothelial Growth Factor A / blood*
Chemical
Reg. No./Substance:
0/Adipokines; 0/Antibodies, Monoclonal, Humanized; 0/Biological Markers; 0/Fumarates; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 0/Resistin; 0/Vascular Endothelial Growth Factor A; 185243-69-0/TNFR-Fc fusion protein; 59-05-2/Methotrexate; 59865-13-3/Cyclosporine; 9007-41-4/C-Reactive Protein; FYS6T7F842/adalimumab

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