Association of biologic therapy with coronary inflammation in patients with psoriasis as assessed by perivascular fat attenuation index

JAMA Aug 05, 2019

Elnabawi YS, Oikonomou EK, Dey AK, et al. - Via performing a cohort study involving 134 consecutive patients with moderate to severe psoriasis, researchers examined the correlation of biologic therapy with coronary inflammation in patients with psoriasis using the perivascular fat attenuation index (FAI)—a novel imaging biomarker that evaluates coronary inflammation by outlining spatial variations of perivascular fat composition through coronary computed tomography angiography (CCTA). Most patients had a low cardiovascular risk, which was determined by traditional risk scores, and moderate to severe skin disease. A total of 82 and 52 patients underwent biologic psoriasis therapy for 1 year and did not receive any biologic therapy and were given topical or light therapy, respectively. Forty-six patients at baseline had focal coronary atherosclerotic plaque. Biologic therapy was correlated with a significant reduction in FAI at 1 year concurrent with skin disease improvement, while no variety in FAI was observed in those who did not get biologic therapy. The correlations with FAI were independent of the presence of coronary plaque and were consistent among individuals who took various biologic agents, including anti-tumor necrosis factor α and anti–interleukin (IL)-12/23 or anti–IL-17 therapy. Overall, biologic therapy for moderate to severe psoriasis was related to decreased coronary inflammation evaluated by perivascular FAI. Moreover, for coronary artery disease, perivascular FAI calculated by CCTA may be utilized to track response to interventions.

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