Does treatment of psoriasis with biologics affect the cardiac outcome?. a study in a group of jordanian patients

Introduction: Psoriasis is one of the major diseases for which patients visit dermatology clinics. Not only it affects the skin, but also its multi-systemic nature is being more recognized. Apart from the well-known psoriatic arthritis, psoriasis has been shown to increase the likelihood of ischemic heart disease, partly due to the stress and lifestyles patients may adopt, and also more importantly and as recently presumed due to the inflammatory nature of the disease. In studies on patients treated with systemic immunomodulators including TNF alpha inhibitors, interleukin-12/23 inhibitors, and interleukin-17 inhibitors, ischemic heart disease showed improvement. Objective: To determine whether or not ischemic heart disease improves with treatment of psoriasis with biological therapy at King Hussein Medical Centre, Jordanian Royal Medical Services. Methods: We aim to assess psoriatic patients who are planned or currently receiving biological treatments for psoriasis at King Hussein Medical Centre for the presence of ischemic heart disease at the cardiology clinics at Queen Alia Heart Institute. We plan to reassess them after clinical psoriasis improvement. Results: All the patients improved more than 50%(according to PASI score) regarding their psoriasis when reevaluated 14 months after starting biologics. About 54% of patients who were found to have non-calcific coronary plaques, showed reduction by 5%-15% in coronary plaque burden after 14 months from starting biologics. Conclusion: Treatment of moderate to severe psoriasis with biological agents has a positive effect in reducing and altering the coronary non-calcific plaque burden.