Study | Treatment for Psoriasis | Cardiovascular Endpoint | Number of Patients | Relative Risk | Population/ Type of Study |
Abuabara et al., 2011 [74] | Systemic immunomodulatory therapies (methotrexate, cyclosporine, alefacept, efalizumab, adalimumab, etanercept, infliximab) | Myocardial infarction | Psoriasis: 25,554; Phototherapy: 4220; Systemic treatment: 20,094; Both treatments: 1240 | Hazard ratio (compared to UVB phototherapy): 1.33 (95% CI 0.90 - 1.96) | United States/ Cohort study |
Ahlehoff et al., 2013 [75] | Biological agents; Methotrexate | Cardiovascular death, myocardial infarction and stroke | Severe psoriasis: 2400; Biological agents: 693; Methotrexate: 799; Other therapies: 908 | Hazard ratio (compared to other therapies): Biological agents: 0.48 (95% CI 0.17 - 1.38); Methotrexate: 0.50 (95% CI 0.26 - 0.97) | Denmark/ Retrospective cohort study |
Ahlehoff et al., 2015 [76] | Methotrexate; Cyclosporine; Retinoids; TNF-α inhibitors; Ustekinumab | Cardiovascular events (cardiovascular death, myocardial infarction, stroke) | Severe psoriasis: 6902; Methotrexate: 3564; Cyclosporine: 244; Retinoids: 756; TNF-α inhibitors: 959; Ustekinumab: 178 | Hazard ratio (compared to other therapies): Methotrexate: 0.53 (95% CI 0.34 - 0.83); Cyclosporine: 1.06 (95% CI 0.26 - 4.27); Retinoids: 1.80 (95% CI 1.03 - 2.96); TNF-α inhibitors: 0.46 (95% CI 0.22 - 0.98); Ustekinumab: 1.52 (95% CI 0.47 - 4.94) | Denmark/ Cohort study |
Chin et al., 2013 [77] | Methotrexate; Retinoid | Cardiovascular disease; Cerebrovascular disease | Psoriasis patients without arthritis: 7648 | Hazard ratio (compared to no methotrexate and no retinoid treatment): Cardiovascular disease: Methotrexate: 0.39 (95% CI 0.20 - 0.76); Retinoid 0.47 (95% CI 0.26 - 0.83); Cerebrovascular disease: Methotrexate: 0.42 (95% CI 0.19 - 0.95); Retinoid: 0.67 (95% CI 0.35 - 1.31) | Taiwan/ Retrospective cohort study |
Lan et al., 2012 [54] | Methotrexate; Retinoid | Cerebrovascular disease | Psoriasis: 8180; Methotrexate: 258; Retinoid: 193 | Hazard ratio (compared to no methotrexate and no retinoid treatment): Methotrexate: 0.50 (95% CI 0.27 - 0.92); Retinoid: 0.70 (95% CI 0.39 - 1.23) | Taiwan/ Retrospective cohort study |
Prodanovich et al., 2005 [78] | Methotrexate | Vascular disease (including cardiovascular disease, cerebrovascular disease, atherosclerosis) | Psoriasis: 7615 | Relative risk (compared to no methotrexate treatment): Methotrexate: 0.73 (95% CI 0.55 - 0.98); Low cumulative dose methotrexate: 0.50 (95% CI 0.31 - 0.79) | United States/ Retrospective cohort study |
Wu et al., 2012 [79] | TNF inhibitor | Myocardial infarction | Psoriasis: 8845; TNF inhibitor: 1673 | Hazard ratio (compared to topical therapy): TNF inhibitor: 0.50 (95% CI 0.32 - 0.79) | United States/ Retrospective cohort study |
Wu et al., 2013 [80] | TNF inhibitor; Oral/phototherapy | Myocardial infarction | Psoriasis: 8845; Caucasians: 4645 (TNF inhibitor: 857; Oral/phototherapy: 1011; Topical: 2777); Non-Caucasians: 4200 (TNF inhibitor: 816; Oral/phototherapy: 1086; Topical: 2298) | Hazard ratio (compared to topical therapy): Caucasians: TNF inhibitors: 0.35 (95% CI 0.20 - 0.62); Oral/phototherapy: 0.36 (95% CI 0.22 - 0.59); Non-Caucasians: TNF inhibitors: 0.27 (95% CI 0.11 - 0.67); Oral/phototherapy: 0.58 (95% CI 0.32 - 1.04) | United States/ Retrospective cohort study |