Faculty of Medicine, Department of Dermatology and Venereology, Uşak University, Uşak Training and Research Hospital, Uşak, Turkey.
Department of Dermatology, Girne Dr. Akcicek State Hosiptal, Kyrenia, Cyprus.
Arch Dermatol Res. 2024 Sep 11;316(8):613. doi: 10.1007/s00403-024-03369-3.
Psoriasis is a chronic inflammatory skin condition associated with systemic inflammation and a higher risk of cardiovascular comorbidities. This study retrospectively evaluates coagulation parameters in psoriasis vulgaris patients treated with IL-17 inhibitors (secukinumab, ixekizumab) and IL-23 inhibitors (risankizumab, guselkumab), compared to those untreated systemically. The study reviewed records from 177 patients treated between January 2019 and March 2023. Patients were grouped into control (n = 77), secukinumab (n = 36), ixekizumab (n = 19), guselkumab (n = 24), and risankizumab (n = 21). Coagulation parameters, including PT, aPTT, PLT, MPV, INR, fibrinogen, D-dimer, and B12 levels, were analyzed. The primary endpoint was the comparison of coagulation parameters between groups. Significant differences were found in PT, with secukinumab-treated patients showing a significantly shorter PT compared to controls (p = 0.002). No significant differences were observed in other coagulation parameters across the groups. The study highlights a potential effect of secukinumab on coagulation pathways, possibly related to IL-17's role in inflammation and endothelial function. Despite current literature suggest a risk of cerebrovascular events with risankizumab, this study did not show any significant changes in coagulation parameters with risankizumab, indicating no hypercoagulability risk associated with this IL-23 inhibitor. Our findings suggest IL-17 and IL-23 inhibitors are generally safe concerning coagulation parameters, but regular monitoring may be warranted for patients on secukinumab due to its effect on PT. Further long-term studies are needed to fully understand the cardiovascular risks associated with these therapies.
银屑病是一种与全身炎症和更高心血管合并症风险相关的慢性炎症性皮肤病。本研究回顾性评估了接受白细胞介素-17 抑制剂（司库奇尤单抗、依奇珠单抗）和白细胞介素-23 抑制剂（瑞莎珠单抗、古塞奇尤单抗）治疗的寻常型银屑病患者的凝血参数，与未接受全身治疗的患者进行比较。该研究回顾了 2019 年 1 月至 2023 年 3 月期间接受治疗的 177 名患者的记录。患者被分为对照组（n=77）、司库奇尤单抗组（n=36）、依奇珠单抗组（n=19）、古塞奇尤单抗组（n=24）和瑞莎珠单抗组（n=21）。分析了凝血参数，包括 PT、aPTT、PLT、MPV、INR、纤维蛋白原、D-二聚体和 B12 水平。主要终点是比较各组之间的凝血参数。PT 存在显著差异，与对照组相比，接受司库奇尤单抗治疗的患者 PT 明显缩短（p=0.002）。各组间其他凝血参数无显著差异。该研究强调了司库奇尤单抗对凝血途径的潜在影响，这可能与白细胞介素-17 在炎症和内皮功能中的作用有关。尽管目前的文献表明瑞莎珠单抗存在脑血管事件风险，但本研究并未显示瑞莎珠单抗治疗与凝血参数的任何显著变化，表明该 IL-23 抑制剂无高凝风险。我们的研究结果表明，白细胞介素-17 和白细胞介素-23 抑制剂在凝血参数方面通常是安全的，但由于司库奇尤单抗对 PT 的影响，可能需要对接受司库奇尤单抗治疗的患者进行定期监测。需要进一步的长期研究来充分了解这些治疗方法与心血管风险的关系。
