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Psoriasis, psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) are chronic immune-mediated inflammatory diseases that require long-term treatment, and are often associated with cardiovascular (CV) disease. A presented at the American College of Rheumatology virtual annual meeting reported the effect of interleukin (IL)-17A inhibition with secukinumab (Cosentyx) on CV risk parameters in psoriasis, PsA, and axSpA patients over 1 year of treatment.

In this video courtesy of , Sheila Reyes, MD, a consultant rheumatologist at the St. Luke's Medical Center in Quezon City, Philippines, describes the results and implications of the study.

Following is a transcript of her remarks:

Evidence shows that patients with psoriasis, psoriatic arthritis, and axSpA carry an increased risk of cardiovascular disease. This risk appears to be mediated by systemic inflammation over and above traditional risk factors. High sensitive CRP [C-reactive protein] is an independent surrogate marker of CV risk and an elevated neutrophil-to-lymphocyte ratio [NLR] is a novel biomarker of systemic inflammation that has emerged as a predictor of prognosis in cardiovascular disease.

IL-17A is a proinflammatory cytokine, and may represent one of the main links between cardiovascular disease in psoriasis, PsA, and axSpA.

The study by Dr. Iain McInnes and colleagues, with abstract number 1835, reported the effect of secukinumab in CV-risk parameters and systemic inflammation among psoriasis, psoriatic arthritis, and axSpA patients. This post-hoc analysis included 9,197 patients from 19 clinical trials. They found that both doses of secukinumab at 150 and 300 mg significantly reduced the median CRP, and NLR at week 12 for psoriasis -- or week 16 for PsA and axSpA -- compared with placebo.

Key traditional cardiometabolic parameters remained stable in secukinumab-treated patients in 1 year.

These findings suggest that the beneficial effects of secukinumab on systemic inflammation go beyond improvement of clinical symptoms, but also reduce cardiovascular risk in this set of patients. CV risk assessment must be evaluated regularly when managing patients with chronic inflammatory diseases like psoriasis, PsA, and axSpA, because these additional risk factors would influence the choice of treatment and potentially optimize outcomes.

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