Adalimumab also reduces vascular inflammation

Montreal - Results of a new pilot study suggest that adalimumab, a tumor necrosis factor inhibitor for the treatment of psoriasis, also reduces vascular inflammation seen in patients with concomitant coronary atherosclerosis.

Medscape Medical News reports that a team of researchers led by Montreal dermatologist Robert Bissonnette, M.D., randomized 30 patients with moderate-to-severe psoriasis and either a history of coronary atherosclerosis, or at least three risk factors, to a standard psoriasis dose of adalimumab or to a control group for 16 weeks. Patients in the control group were allowed to choose between their own nonsystemic treatment or no treatment. All subjects underwent baseline and end-of-study tomography with injection of 18-fluorodeoxyglucose so that vascular inflammation in the aorta and carotid arteries could be quantified.

Medscape quotes Dr. Bissonnette as saying, “Our hypothesis was that the treatment of psoriasis with a product effective for skin lesions would also improve vascular inflammation.”

At the end of the study, imaging results showed that in the adalimumab group, there was a statistically significant decrease of 12 percent in vascular inflammation, compared with a nonsignificant change in the control group. The difference between the groups did not reach statistical significance. When the arteries were examined separately, however, inflammation in the aorta and carotid arteries was significantly lower in the adalimumab group than in the control group.

According to Dr. Bissonnette, if these findings are reproduced in larger studies they suggest that in addition to alerting patients with psoriasis about their increased risk for atherosclerosis, dermatologists may be able to modify that risk with targeted psoriasis treatment.

Medscape quotes David Siegel, M.D., vice chairman of medicine at the University of California, Davis, as commenting, “While an interesting outcome for adalimumab, I would caution that what was measured is an intermediary outcome. Stronger evidence would be a study that shows a benefit in clinical outcomes of atherosclerosis in psoriatic patients treated with adalimumab.”

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