Some Psoriasis Therapies May Cut Heart Attack Risk
People on TNF Inhibitors, Oral or Light Therapy Less Likely to Have Heart Attacks, Researchers Find
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Psoriasis & Heart Attack Risk: Study Details continued...
When Wu compared TNF inhibitors directly with the oral medicine and light therapy, the TNF inhibitors were found only slightly better in reducing heart attack risk.
Wu says he combined the oral agent and light therapy groups to simplify the research.
There was no information available on the severity of the psoriasis, Wu says.
Generally, topical medications are offered first, and if they don't give enough relief, patients may be offered the other treatments.
Topical treatments slow down the rapid growth of skin cells and reduce the inflammation. Light therapy slows down the rapid cell growth. Oral medicines such as methotrexate and the TNF inhibitors reduce inflammation in the entire body.
It is possible some with severe disease chose to get topical treatment, Wu says.
Wu reports receiving research grants from Abbott Laboratories, Amgen, and Pfizer. All market or are developing psoriasis medicines.
None of the grants are related to the current study. The study was supported by Kaiser Permanente Garfield Memorial Fund.
Psoriasis Treatments: Cost Considerations
TNF inhibitor treatment is very costly. The drugs are given by injection or intravenously. Annual cost for the three drugs evaluated in the study ranges from about $17,000 to $23,000 a year. Some patients pay only a copay.
Generic methotrexate is about $20 a month, or about $250 a year.
However, patients on that drug do need to undergo routine lab tests for monitoring.
Patients in the Kaiser plan get light therapy for the cost of a visit copayment, Wu says.
He says patients with severe disease, in particular, may want to consider long-term benefits of reducing inflammation.
"If you have severe psoriasis, it may be beneficial to be on some sort of treatment -- TNF inhibitors, methotrexate, that in itself will help with the psoriasis and may help with systemic inflammation and reduce accompanying diseases," Wu says.
Psoriasis Treatments & Heart Attacks: Perspective
"This study gives the patient a little more comfort in knowing if their psoriasis is severe enough to warrant treatment, TNF inhibitors, photo therapy, and oral agents compared to topical treatment may reduce the risk of having a heart attack," says Nehal N. Mehta, MD, chief of the section of inflammatory and cardiometabolic diseases at the National Heart, Lung and Blood Institute.
"People used to think psoriasis was a cosmetic disease," he says. The new research, he says, supports the notion that treating severe psoriasis with TNF inhibitors, oral agents, or light therapy may improve heart attack risk.