Association between systemic anti-psoriatic drugs and cardiovascular risk in patients with psoriasis and psoriatic arthritis: A nationwide cohort study
Arthritis & Rheumatism,
Chen YJ et al. – Among patients with psoriasis and psoriatic arthritis, the adjusted risk of hospitalized ischemic heart diseases (IHD) for individuals starting methotrexate (MTX) was comparable with those starting with other nonbiologic anti–psoriatic drugs.Methods
- A retrospective cohort study among 179,200 patients with a diagnosis of psoriasis or psoriatic arthritis on at least 3 visits.
- The authors conducted the analyses by using the National Health Insurance Research Database of Taiwan.
- The risk of new IHD hospitalizations was compared between psoriasis patients taking MTX monotherapy (MTX cohort) and those taking nonbiologic anti–psoriatic drugs other than MTX (reference cohort).
- Additional adjustments were made for cardiovascular risk factors, number of hospital visits, Charlson score and use of other anti–inflammatory drugs.
- The study cohorts consisted of 6,578 patients in MTX cohort and 5,471 subjects in reference cohort between January 1996 and December 2008.
- The incidence rates of IHDs were 666 and 830 cases per 100,000 person–years in MTX–treated cohort and reference cohort, respectively (p=0.027, unadjusted).
- Increasing age, males, hypertension, diabetes, and use of phototherapies were independent risk factors for new IHD hospitalizations in study cohorts.
- However, the multivariate adjusted hazard ratio for hospitalized IHD was 0.97 (95% confidence interval 0.79–1.19) for MTX, in comparison with other nonbiologic anti–psoriatic drugs after adjustment of age, gender, comorbidity index, hospital visits and treatments of psoriasis.