Biologic Agents Improve Psoriasis Comorbidities Such as Depression and CAD

Coping with severe depression.
Coping with severe depression.
Biologic agents should be considered for treatment of patients with psoriasis comorbidities including depressive symptoms and coronary artery disease.

The following article is part of coverage from the American Academy of Dermatology’s Annual Meeting (AAD 2020). Because of concerns regarding the coronavirus disease 2019 (COVID-19) pandemic, all AAD 2020 sessions and presentations were transitioned to a virtual format. While live events will not proceed as planned, readers can click here to view more news related to research presented during the AAD VMX 2020 virtual experience.

Biologic agents improved comorbidities of psoriasis, including depressive symptoms and coronary artery disease, according to study results presented at the American Academy of Dermatology’s Virtual Meeting Experience (AAD VMX) 2020, held online from June 12 to 14, 2020.

Researchers conducted a systematic review of studies that included patients with psoriasis and psoriatic comorbidities. Only studies that reported on the use of biologic agents were included in the review. A total of 34 studies selected for the review included studies that discussed the effect of biologic agents on cardiovascular disease and related events, depression and anxiety, malignancies, psoriatic arthritis, and infection.

Treatment with biologic agents was associated with reductions in depressive symptoms (IR, 3.01; 95% CI, 2.73-3.32; hazard ratio [HR], 0.76; 95% CI, 0.59-0.98; P =.0367), particularly when compared with non-biologic agents (IR, 5.70; 95% CI, 4.58-7.1; P value unreported) and phototherapy (IR, 5.85; 95% CI, 4.29-7.97; P value unreported). Biologic agents were also associated with a significant reduction in the risk for coronary artery disease (P <.01).

There was no association between treatment with biologic agents and an increased risk for malignancy. Patients treated with biologic agents did experience an increased risk for nonmelanoma skin cancers compared with patients treated with nonbiologic agents (adjusted HR, 1.42; 95% CI, 1.12-1.80). The investigators noted inconsistent findings in regard to the effect of biologic agents on infection risk, with 9 studies that reported increased risk for infections vs 5 studies that reported no change in risk. In contrast, 1 study reported a reduced risk for infection with biologic agents.

The researchers concluded that “biologic use should be considered for psoriasis patients with depression, psoriatic arthritis and coronary artery disease” as well as “in patients with nonmelanoma skin cancer.”

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Sachdeva M, Shah M, Pona A, et al. The influence of biologics on psoriasis comorbidities: A systematic review. Presented at: AAD VMX 2020; June 12-14, 2020. Abstract/Poster 18630.