The risk of cardiovascular events in psoriasis patients treated with tumor necrosis factor–? inhibitors versus phototherapy: An observational cohort study - 18/06/18
, Murali Sundaram, MBA, PhD b, Martin Cloutier, MSc c, Marjolaine Gauthier-Loiselle, PhD c, Annie Guérin, MSc c, Rakesh Singh, PhD d, Arijit Ganguli, PhD dAbstract |
Background |
Psoriasis is a risk factor for cardiovascular events.
Objective |
To assess the risk of major cardiovascular events and the effect of cumulative treatment exposure on cardiovascular event risk in patients with psoriasis treated with tumor necrosis factor–α inhibitors (TNFis) versus phototherapy.
Methods |
Adult patients with psoriasis were selected from a large US administrative claims database (from the first quarter of 2000 through the third quarter of 2014) and classified in 2 mutually exclusive cohorts based on whether they were treated with TNFis or phototherapy. Cardiovascular event risk was compared between cohorts using multivariate Cox proportional hazards models. Cumulative exposure was defined based on treatment persistence.
Results |
A total of 11,410 TNFi and 12,433 phototherapy patients (psoralen plus ultraviolet A light phototherapy, n = 1117; ultraviolet B light phototherapy, n = 11,316) were included in this study. TNFi patients had a lower risk of cardiovascular events compared to phototherapy patients (adjusted hazard ratio 0.77, P < .05). The risk reduction associated with 6 months of cumulative exposure was 11.2% larger for patients treated with TNFis compared to phototherapy (P < .05).
Limitations |
Information on psoriasis severity and mortality was limited/not available.
Conclusions |
Patients with psoriasis who were treated with TNFis exhibited a lower cardiovascular event risk than patients treated with phototherapy. Cumulative exposure to TNFis was associated with an incremental cardiovascular risk reduction compared to phototherapy.
Le texte complet de cet article est disponible en PDF.Key words : cardiovascular event, cumulative exposure, myocardial infarction, phototherapy, psoriasis, stroke, transient ischemic attack, tumor necrosis factor–α inhibitors, unstable angina
Abbreviations used : CCI, CV, ICD-9, MI, Ps, PUVA, TNFi, UVB
Plan
| The design, study conduct, and financial support for the study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the publication. |
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| Dr Wu is an investigator for AbbVie, Amgen, Eli Lilly, Janssen, Novartis, and Regenron. Dr Sundaram is a former employee of AbbVie and may own AbbVie stock. Mr Cloutier, Dr Gauthier-Loiselle, and Ms Guérin are employed by Analysis Group, which received payment from AbbVie to assist with data analysis. Drs Singh and Ganguli are employees of AbbVie and may own stock. |
Vol 79 - N° 1
P. 60-68 - juillet 2018 Retour au numéro
Article précédent
- Pathologist characteristics associated with accuracy and reproducibility of melanocytic skin lesion interpretation
- David E. Elder, Michael W. Piepkorn, Raymond L. Barnhill, Gary M. Longton, Heidi D. Nelson, Stevan R. Knezevich, Margaret S. Pepe, Patricia A. Carney, Linda J. Titus, Tracy Onega, Anna N.A. Tosteson, Martin A. Weinstock, Joann G. Elmore
- Commentary: Does biologic treatment of psoriasis lower the risk of cardiovascular events and mortality? : A critical question that we are only just beginning to answer
- Joel M. Gelfand
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