Cardiovascular event risk assessment in psoriasis patients treated with tumor necrosis factor-? inhibitors versus methotrexate - 18/04/17
, Annie Guérin, MA b, Murali Sundaram, PhD c, Katherine Dea, MA b, Martin Cloutier, MA b, Parvez Mulani, PhD cAbstract |
Background |
Psoriasis is associated with increased risk for cardiovascular disease.
Objective |
To compare major cardiovascular event risk in psoriasis patients receiving methotrexate or tumor necrosis factor-α inhibitor (TNFi) and to assess TNFi treatment duration impact on major cardiovascular event risk.
Methods |
Adult psoriasis patients with ≥2 TNFi or methotrexate prescriptions in the Truven MarketScan Databases (Q1 2000–Q3 2011) were classified as TNFi or methotrexate users. The index date for each of these drugs was the TNFi initiation date or a randomly selected methotrexate dispensing date, respectively. Cardiovascular event risks and cumulative TNFi effect were analyzed by using multivariate Cox proportional-hazards models.
Results |
By 12 months, TNFi users (N = 9148) had fewer cardiovascular events than methotrexate users (N = 8581) (Kaplan-Meier rates: 1.45% vs 4.09%: P < .01). TNFi users had overall lower cardiovascular event hazards than methotrexate users (hazard ratio = 0.55; P < .01). Over 24 months' median follow-up, every 6 months of cumulative exposure to TNFis were associated with an 11% cardiovascular event risk reduction (P = .02).
Limitations |
Lack of clinical assessment measures.
Conclusions |
Psoriasis patients receiving TNFis had a lower major cardiovascular event risk compared to those receiving methotrexate. Cumulative exposure to TNFis was associated with a reduced risk for major cardiovascular events.
Le texte complet de cet article est disponible en PDF.Key words : psoriasis, cardiovascular event risk, methotrexate, tumor necrosis factor-α inhibitors, myocardial infarction, stroke, transient ischemic attack, unstable angina
Abbreviations used : CI, CST, CV, HIPAA, HR, ICD-9, MI, MTX, Ps, SD, TIA, TNFi, UA
Plan
| Design, study conduct, and financial support for the study were provided by AbbVie; AbbVie participated in the interpretation of data, review, and approval of the abstract; all authors contributed to the development of the publication and maintained control over the final content. |
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| Disclosure: Annie Guérin, Katherine Dea, and Martin Cloutier are employed by Analysis Group, which received payment from AbbVie to assist with data analysis. Dr Wu received research funding from AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Coherus BioSciences, Dermira, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Regeneron, Sandoz, and Sun Pharmaceutical Industries; he is a consultant for AbbVie, Amgen, Celgene, Dermira, Eli Lilly, Pfizer, Regeneron, and Sun Pharmaceutical Industries. Dr Sundaram and Dr Mulani are employees of AbbVie. |
Vol 76 - N° 1
P. 81-90 - janvier 2017 Retour au numéro
Article précédent
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