Biologic therapies anti-interleukin (IL)-12 and IL-23 [anti-IL-12/23] and anti-tumor necrosis factor α (TNF-α) in patients with chronic plaque psoriasis (CPP) do not increase the risk of major adverse cardiovascular events (MACEs), according to a meta-analysis published online Aug. 24 in the Journal of the American Medical Association.
Caitriona Ryan, MB, BAO, BCh, from the Baylor Research Institute in Dallas, and colleagues reviewed available literature to May 2011 to evaluate the association between biologic therapies for CPP and MACEs. A total of 22 randomized controlled trials on anti-IL-12/23 agents and anti-TNF-α agents used for treating CPP, and including 10,183 patients were reviewed. Studies of psoriatic arthritis were excluded from the analysis. MACE, a composite end point of myocardial infarction, cerebrovascular accident, or cardiovascular death during the placebo controlled phase of treatment in patients receiving at least one study agent dose or placebo was the main outcome measure. Absolute risk differences were calculated as an effect measure.
The investigators identified no evidence of statistical heterogeneity across the studies. In the anti-IL-12/23 studies, MACE was observed during placebo-controlled phases in 10 of 3,179 patients receiving anti-IL-12/23 therapy compared to zero events in 1,474 patients on placebo (Mantel-Haenszel risk difference, 0.012 events/person-year). In TNF-α studies, MACE was observed in one of 3,858 and one of 1,812 patients receiving anti-TNF-α agents and placebo, respectively (Mantel-Haenszel risk difference, −0.0005 events/person-year).
"Compared with placebo, there was no significant difference in the rate of MACEs observed in patients receiving anti-IL-12/IL-23 antibodies or anti-TNF-α treatments," the authors write.
Several of the study authors disclosed financial relationship with the pharmaceutical industry.
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