title: Anti-tumor necrosis factor-alpha therapy improves endothelial function and arterial stiffness in patients with moderate to severe psoriasis: A 6-month prospective study.
abstract: The aim of the present study was to determine if the use of the anti-tumor necrosis factor (TNF)-α monoclonal antibody adalimumab could improve endothelial function and arterial stiffness in patients with moderate to severe psoriasis. This was a prospective study on a series of consecutive patients with moderate to severe psoriasis who completed 6 months of therapy with adalimumab. Patients with history of cardiovascular events, diabetes mellitus, kidney disease, hypertension or body mass index of 35 kg/m2or more were excluded. Assessment of endothelial function by brachial artery reactivity measuring flow-mediated endothelial dependent vasodilatation (FMD%), and carotid arterial stiffness by pulse wave velocity (PWV) was performed at the onset of treatment (time 0) and at month 6. Twenty-nine patients were studied. Anti-TNF-α adalimumab therapy yielded a significant improvement of endothelial function. The mean ± standard deviation (SD) FMD% values increased from 6.19 ± 2.44% at the onset of adalimumab to 7.46 ± 2.43% after 6 months of treatment with this biologic agent (P = 0.008). Likewise, following the use of adalimumab, PWV levels decreased from 6.28 ± 1.04 m/s at the onset of adalimumab to 5.69 ± 1.31 m/s at 6 months (P = 0.03). In conclusion, patients with moderate to severe psoriasis exhibit improvement of endothelial function and arterial stiffness following anti-TNF-α therapy. These findings are of potential relevance due to increased risk of cardiovascular disease in patients with severe psoriasis.
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Trinitario
authors.initials: T
authors.lastname: Pina
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Corrales
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Lopez-Mejias
authors.affiliation: Dermatology Division, IDIVAL, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Armesto
authors.affiliation: Dermatology Division, IDIVAL, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Marcos A
authors.initials: MA
authors.lastname: Gonzalez-Lopez
authors.affiliation: Department of Epidemiology and Computational Biology, School of Medicine, IDIVAL, University of Cantabria and CIBER Epidemiología y Salud Pública (CIBERESP), Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Ines
authors.initials: I
authors.lastname: Gómez-Acebo
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Ubilla
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Remuzgo-Martínez
authors.affiliation: Pathology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Gonzalez-Vela
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Blanco
authors.affiliation: Department of Internal Medicine, IDIVAL, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Hernández
authors.affiliation: Dermatology Division, IDIVAL, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.affiliation: Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain. miguelaggay@hotmail.com.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gonzalez-Gay
mesh_terms: D000068879:Adalimumab / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab
keywords: anti-tumor necrosis factor-α therapy; arterial stiffness; atherosclerosis; endothelial function; psoriasis