PMID- 31365032
OWN - NLM
STAT- MEDLINE
DCOM- 20200708
LR  - 20220317
IS  - 2380-6591 (Electronic)
IS  - 2380-6583 (Print)
VI  - 4
IP  - 9
DP  - 2019 Sep 1
TI  - Association of Biologic Therapy With Coronary Inflammation in Patients With 
      Psoriasis as Assessed by Perivascular Fat Attenuation Index.
PG  - 885-891
LID - 10.1001/jamacardio.2019.2589 [doi]
AB  - IMPORTANCE: Psoriasis is a chronic inflammatory skin disease associated with 
      increased coronary plaque burden and cardiovascular events. Biologic therapy for 
      psoriasis has been found to be favorably associated with luminal coronary plaque, 
      but it is unclear whether these associations are attributable to direct 
      anti-inflammatory effects on the coronary arteries. OBJECTIVE: To investigate the 
      association of biologic therapy with coronary inflammation in patients with 
      psoriasis using the perivascular fat attenuation index (FAI), a novel imaging 
      biomarker that assesses coronary inflammation by mapping spatial changes of 
      perivascular fat composition via coronary computed tomography angiography (CCTA). 
      DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study performed from 
      January 1, 2013, through March 31, 2019, analyzed changes in FAI in patients with 
      moderate to severe psoriasis who underwent CCTA at baseline and at 1 year and 
      were not receiving biologic psoriasis therapy at baseline. EXPOSURES: Biologic 
      therapy for psoriasis. MAIN OUTCOMES AND MEASURES: Perivascular FAI mapping was 
      performed based on an established method by a reader blinded to patient 
      demographics, visit, and treatment status. RESULTS: Of the 134 patients (mean 
      [SD] age, 51.1 [12.1] years; 84 [62.5%] male), most had low cardiovascular risk 
      by traditional risk scores (median 10-year Framingham Risk Score, 3% 
      [interquartile range, 1%-7%]) and moderate to severe skin disease. Of these 
      patients, 82 received biologic psoriasis therapy (anti-tumor necrosis factor alpha, 
      anti-interleukin [IL] 12/23, or anti-IL-17) for 1 year, and 52 did not receive 
      any biologic therapy and were given topical or light therapy (control group). At 
      baseline, 46 patients (27 in the treated group and 19 in the untreated group) had 
      a focal coronary atherosclerotic plaque. Biologic therapy was associated with a 
      significant decrease in FAI at 1 year (median FAI -71.22 HU [interquartile range 
      (IQR), -75.85 to -68.11 HU] at baseline vs -76.09 HU [IQR, -80.08 to -70.37 HU] 
      at 1 year; P < .001) concurrent with skin disease improvement (median PASI, 7.7 
      [IQR, 3.2-12.5] at baseline vs 3.2 [IQR, 1.8-5.7] at 1 year; P < .001), whereas 
      no change in FAI was noted in those not receiving biologic therapy (median FAI, 
      -71.98 [IQR, -77.36 to -65.64] at baseline vs -72.66 [IQR, -78.21 to -67.44] at 1 
      year; P = .39). The associations with FAI were independent of the presence of 
      coronary plaque and were consistent among patients receiving different biologic 
      agents, including anti-tumor necrosis factor alpha (median FAI, -71.25 [IQR, -75.86 
      to -66.89] at baseline vs -75.49 [IQR, -79.12 to -68.58] at 1 year; P < .001) and 
      anti-IL-12/23 or anti-IL-17 therapy (median FAI, -71.18 [IQR, -75.85 to -68.80] 
      at baseline vs -76.92 [IQR, -81.16 to -71.67] at 1 year; P < .001). CONCLUSIONS 
      AND RELEVANCE: In this study, biologic therapy for moderate to severe psoriasis 
      was associated with reduced coronary inflammation assessed by perivascular FAI. 
      This finding suggests that perivascular FAI measured by CCTA may be used to track 
      response to interventions for coronary artery disease.
FAU - Elnabawi, Youssef A
AU  - Elnabawi YA
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Oikonomou, Evangelos K
AU  - Oikonomou EK
AD  - Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University 
      of Oxford, Oxford, United Kingdom.
FAU - Dey, Amit K
AU  - Dey AK
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Mancio, Jennifer
AU  - Mancio J
AD  - Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University 
      of Oxford, Oxford, United Kingdom.
FAU - Rodante, Justin A
AU  - Rodante JA
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Aksentijevich, Milena
AU  - Aksentijevich M
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Choi, Harry
AU  - Choi H
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Keel, Andrew
AU  - Keel A
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Erb-Alvarez, Julie
AU  - Erb-Alvarez J
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Teague, Heather L
AU  - Teague HL
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Joshi, Aditya A
AU  - Joshi AA
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Playford, Martin P
AU  - Playford MP
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Lockshin, Benjamin
AU  - Lockshin B
AD  - DermAssociates, Silver Spring, Maryland.
FAU - Choi, Andrew D
AU  - Choi AD
AD  - Division of Cardiology, The George Washington University School of Medicine, 
      Washington, District of Columbia.
FAU - Gelfand, Joel M
AU  - Gelfand JM
AD  - Department of Dermatology, University of Pennsylvania, Philadelphia.
FAU - Chen, Marcus Y
AU  - Chen MY
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Bluemke, David A
AU  - Bluemke DA
AD  - Department of Radiology, University of Wisconsin, Madison.
FAU - Shirodaria, Cheerag
AU  - Shirodaria C
AD  - Caristo Diagnostics, Oxford, United Kingdom.
FAU - Antoniades, Charalambos
AU  - Antoniades C
AD  - Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University 
      of Oxford, Oxford, United Kingdom.
FAU - Mehta, Nehal N
AU  - Mehta NN
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
LA  - eng
GR  - FS/16/15/32047/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JAMA Cardiol
JT  - JAMA cardiology
JID - 101676033
RN  - 0 (Biological Factors)
SB  - IM
CIN - JAMA Cardiol. 2020 Mar 1;5(3):359. PMID: 31913402
CIN - JAMA Cardiol. 2020 Mar 1;5(3):359-360. PMID: 31913410
CIN - J Cutan Med Surg. 2020 Mar/Apr;24(2):209-210. PMID: 32208025
MH  - Adipose Tissue/*diagnostic imaging
MH  - Biological Factors/*therapeutic use
MH  - Biological Therapy/*methods
MH  - Computed Tomography Angiography/methods
MH  - Coronary Angiography/methods
MH  - Coronary Artery Disease/*complications/diagnosis
MH  - Coronary Vessels/*diagnostic imaging/drug effects
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Inflammation/complications/diagnosis/*therapy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - Psoriasis/complications/diagnosis/*therapy
MH  - Severity of Illness Index
MH  - Time Factors
PMC - PMC6669789
COIS- Conflict of Interest Disclosures: Dr Oikonomou reported having a pending and 
      licensed patent to a novel tool for cardiovascular risk stratification based on 
      the computed tomographic attenuation of perivascular tissue (OxScore) and a 
      pending and licensed patent to perivascular texture index. Dr Erb-Alvarez 
      reported being a full-time US government employee. Dr Lockshin reported receiving 
      personal fees and/or other from Eli Lilly, Novartis, Celgene, Abbvie, and Janssen 
      outside the submitted work. Dr Gelfand reported receiving personal fees from BMS, 
      Boehringer Ingelheim, Janssen Biologics, Novartis Corp, UCB (data safety 
      monitoring board), Sanofi, and Pfizer Inc and receiving grants from Abbvie, 
      Boehringer Ingelheim, Janssen, Novartis Corp, Celgene, Ortho Dermatologics, and 
      Pfizer Inc outside the submitted work. Dr Shirodaria reported having an issued 
      patent to PCT/GB2015/052359. Dr Antoniades reported receiving personal fees from 
      Caristo Diagnostics during the conduct of the study and having a pending, issued, 
      licensed, and with royalties paid patent to PCT/GB2015/05235 and 
      PCT/GB2016/1620494.3 and pending patents to GB2018/1818049.9, GR2018/0100490, and 
      GR2018/0100510. Dr Mehta reported being a full-time US government employee and 
      serving as a consultant to and receiving grants or other payments from Amgen, Eli 
      Lilly, and Leo Pharma; serving as a principal investigator and/or investigator to 
      and receiving grants and/or research funding from AbbVie, Celgene, Janssen 
      Pharmaceuticals, Inc, and Novartis; and serving as a principal investigator and 
      receiving grants and/or research funding from the National Institutes of Health 
      (NIH). No other disclosures were reported.
EDAT- 2019/08/01 06:00
MHDA- 2020/07/09 06:00
PMCR- 2020/07/31
CRDT- 2019/08/01 06:00
PHST- 2019/08/01 06:00 [pubmed]
PHST- 2020/07/09 06:00 [medline]
PHST- 2019/08/01 06:00 [entrez]
PHST- 2020/07/31 00:00 [pmc-release]
AID - 2740281 [pii]
AID - hoi190043 [pii]
AID - 10.1001/jamacardio.2019.2589 [doi]
PST - ppublish
SO  - JAMA Cardiol. 2019 Sep 1;4(9):885-891. doi: 10.1001/jamacardio.2019.2589.