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Some Psoriasis Therapies May Cut Heart Attack Risk

People on TNF Inhibitors, Oral or Light Therapy Less Likely to Have Heart Attacks, Researchers Find
By
WebMD Health News
Reviewed by Louise Chang, MD

EKG

Aug. 20, 2012 -- People with psoriasis, known to be at higher risk of heart attack, had a lower risk when treated with drugs known as tumor necrosis factor (TNF) inhibitors, such as Enbrel, Humira or Remicade, compared to medicines applied to the skin, according to new research. 

Those on oral medicines such as cyclosporine, methotrexate, Soriatane, or given light therapy had nearly the same reduction in risk, compared to those on skin-based -- or topical -- medicines.

The study was a look back at almost 9,000 patients with the skin disorder psoriasis. They got four different types of treatments. Researchers compared the number of heart attacks in the groups during a four-year follow-up.

The inflammation associated with the skin condition is also linked to an increased risk of heart attack and other vascular problems such as stroke.

"We found those in the TNF inhibitor group had a 50% reduction in heart attack compared to the topical agent group," says Jashin J. Wu, MD, director of dermatology research and associate dermatology residency program director at Kaiser Permanente Los Angeles Medical Center.

"Those in the phototherapy or oral medicine group had a 46% reduction compared to topical," he says. The research found only a link, he says, not cause and effect.

The study results are published in the Archives of Dermatology.

Psoriasis & Heart Attack: Why?

Psoriasis affects about 3% of Americans, according to Wu.

In psoriasis, the immune system sends out faulty signals. The growth cycle of skin cells speeds up too much, according to the National Psoriasis Foundation.

There are five types. The most common, called plaque, looks like red, raised patches covered with silvery white dead skin cells.

Psoriasis can occur anywhere on the body, including eyelids, ears, mouth, lips, hands, feet, skin folds, and nails, according to the foundation.

It is not just a cosmetic problem. Psoriasis keeps the body in a constant inflammatory state. That increases the risk of heart attack and other problems, including diabetes, according to Wu and other experts.

Psoriasis & Heart Attack Risk: Study Details

Wu wanted to see if one treatment was better than another for reducing heart attack risk.

At the study start, in 2004, no one had had a heart attack. Wu's team looked at the incidence of heart attack until November 2010.

Of the 8,845 patients, who were on average about 53 years old:

During the follow-up, heart attacks occurred in:

  • 152 on topical medicines
  • 41 on oral or light therapy
  • 28 on TNF inhibitors
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