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    Beyond the plaque

    Psoriasis patients may suffer metabolic problems

     

    Emerging evidence

    There is new research in psoriasis comorbidities, including in the areas of sleep disturbance and sleep apnea, COPD and peptic ulcer disease, which show potential links to psoriasis.

    “Time will tell if these are truly related to psoriasis, or if it’s by chance. There’s not enough data yet to know for certain,” he says.

    Dr. Blauvelt says the most interesting science going on related to co-morbidities are the studies that are looking at how effective treatments for psoriasis may decrease the risk for cardiovascular disease.

    “If these studies show that clearing skin leads to improvements in systemic inflammation and fewer heart attacks and strokes, then this will represent a major clinical turning point in how we approach and manage our patients with extensive psoriasis," Dr. Blauvelt says. 

    The bottom line, according to Dr. Gelfand, is for dermatologists to think holistically about psoriasis patients.

    “By doing that, we hope to have better outcomes not only in the skin but also for their long-term health and wellbeing,” he says. “I think one of the major things colleagues should know about is work that we’ve done showing that people with psoriasis who go on systemic therapies have the same increased rates of mortality and cardiovascular disease as people who have rheumatoid arthritis. That’s a striking finding. And the only way we can help reverse the comorbidity curve is by educating our patients and by advocating for appropriate preventive care.”

    References:

    1. Gelfand JM. Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom. J Invest Dermatol. 2012 Mar;132(3 Pt 1):556-62. http://www.ncbi.nlm.nih.gov/pubmed/22113483.

    2. Ogdie A, Yu Y, Haynes K, Love TJ, Maliha S, Jiang Y, Troxel AB, Hennessy S, Kimmel SE, Margolis DJ, Choi H, Mehta NN, Gelfand JM. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2015 Feb;74(2):326-32. http://www.ncbi.nlm.nih.gov/pubmed/25351522

    3. Naik HB, Natarajan B, Stansky E, Ahlman MA, Teague H, Salahuddin T, Ng Q, Joshi AA, Krishnamoorthy P, Dave J, Rose SM, Doveikis J, Playford MP, Prussick RB, Ehrlich A, Kaplan MJ, Lockshin BN, Gelfand JM, Mehta NN. Severity of Psoriasis Associates With Aortic Vascular Inflammation Detected by FDG PET/CT and Neutrophil Activation in a Prospective Observational Study. Arterioscler Thromb Vasc Biol. 2015 Dec;35(12):2667-76.http://www.ncbi.nlm.nih.gov/pubmed/26449753

    Disclosures:

    Dr. Blauvelt has served as a scientific adviser and clinical study investigator for AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Celgene, Dermira, Genentech, GSK, Janssen, Lilly, MedImmune, Merck, Novartis, Pfizer, Regeneron, Sandoz, Sanofi, Sun, UCB, and Valeant, and as a paid speaker for Lilly.

    Dr. Gelfand has relationships (such as financial, consulting or research) with Amgen, Coherus, Janssen, Celgene, Astrazenec, Novartis, Pfizer, Sanofi, Valeant and various CME entities.

    Lisette Hilton
    Lisette Hilton is president of Words Come Alive, based in Boca Raton, Florida.

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