Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Dermatol. 2023 Nov;50(11):1442-1449. doi: 10.1111/1346-8138.16904. Epub 2023 Jul 30.
The effect of antipsoriatic therapy on cardio-cerebrovascular disease (CCVD) is not well described. Thus, we performed a population-based nested case-control study to investigate the effect of systemic antipsoriatic therapy on CCVD in psoriasis patients. Using nationwide cohort data from the Korean National Health Insurance Claims database, newly diagnosed psoriasis patients were identified. Among the enrolled participants, postenrollment development of CCVD events (ischemic heart disease, myocardial infarction, cerebral infarction, and cerebral hemorrhage) was investigated. To evaluate the effect of systemic antipsoriatic therapy on CCVD risk, we calculated the proportion of the treatment period with systemic antipsoriatic therapy during the study period (PTP [%]: the sum of all systemic antipsoriatic therapy durations divided by total observation period). Among 251 813 participants, 6262 experienced CCVD events during the study period (CCVD group). Controls included 245 551 patients without CCVD history during the study period (non-CCVD group). The non-CCVD group had greater PTP than the CCVD group (CCVD 2.12 ± 7.92, non-CCVD 2.64 ± 9.64; P < 0.001). In multiple logistic regression analysis, PTP was inversely associated with the CCVD risk after adjusting for age, sex, diabetes, hypertension, and dyslipidemia. A 10% increase in PTP reduced CCVD risk by 0.96 (95% confidence interval 0.93 to 0.99). Reduced CCVD risk was robust for both conventional antipsoriatic therapy and biologics. Our study found that systemic antipsoriatic therapy use was inversely associated with CCVD risk in psoriasis patients. These findings suggested that systemic antipsoriatic therapy could reduce CCVD development in patients with psoriasis.
抗银屑病疗法对心脑血管疾病（CCVD）的影响尚未得到充分描述。因此，我们进行了一项基于人群的巢式病例对照研究，以调查银屑病患者接受系统性抗银屑病治疗对 CCVD 的影响。我们使用来自韩国国家健康保险索赔数据库的全国性队列数据，确定了新诊断的银屑病患者。在纳入的参与者中，调查了 CCVD 事件（缺血性心脏病、心肌梗死、脑梗死和脑出血）的发生情况。为了评估系统性抗银屑病治疗对 CCVD 风险的影响，我们计算了研究期间接受系统性抗银屑病治疗的治疗期比例（PTP [%]：所有系统性抗银屑病治疗持续时间之和除以总观察期）。在 251813 名参与者中，6262 名在研究期间发生了 CCVD 事件（CCVD 组）。对照组包括 245551 名在研究期间无 CCVD 病史的患者（非 CCVD 组）。非 CCVD 组的 PTP 大于 CCVD 组（CCVD 2.12±7.92，非 CCVD 2.64±9.64；P<0.001）。在调整年龄、性别、糖尿病、高血压和血脂异常后，多因素逻辑回归分析显示，PTP 与 CCVD 风险呈负相关。PTP 增加 10%，CCVD 风险降低 0.96（95%置信区间 0.93 至 0.99）。常规抗银屑病治疗和生物制剂均具有降低 CCVD 风险的稳健性。我们的研究发现，系统性抗银屑病治疗与银屑病患者的 CCVD 风险呈负相关。这些发现表明，系统性抗银屑病治疗可能会降低银屑病患者的 CCVD 发生风险。
