Age of Psoriasis Onset Linked to MI, Risk Lessened With Biologic Therapy

Patients who develop psoriasis before the age of 25 have a 9-fold increased risk of having a myocardial infarction (MI), but biologic therapy may offer protection from such cardiac events, according to a study presented here at the 73rd Annual Meeting of the American Academy of Dermatology (AAD).

"There is a well-documented risk of cardiovascular disease [in patients with psoriasis], but we don't know who is at risk," said Wayne Gulliver MD, Memorial University of Newfoundland, St. John's, Newfoundland. "We know that patients with psoriasis die earlier, and we know most patients with psoriasis die of cardiovascular disease."

Dr. Gulliver and colleagues looked at the records of 178 cases of patients with moderate-to-severe plaque psoriasis and 440 matched controls.

They found psoriasis onset before age 25 meant a relative risk of having an MI of 8.852, or an 885% elevated risk. They also found biologic therapy conferred protection of risk from an MI, with the relative risk being 0.176, meaning an 83% reduced risk of having an MI when biologic therapy was initiated for at least 1 month in patients.

Investigators looked at the impact of several biologic agents on the risk of MI developing in patients with moderate-to-severe plaque psoriasis, noted Dr. Gulliver. The application of this information can be used immediately in the primary care setting, he said.

"It would be very simple to screen patients in your office," said Dr. Gulliver. "You would need to ask them how old they were when they developed psoriasis. This is a practical question that physicians can ask in their offices."

"We can't screen every young patient for cardiovascular disease, but if you find out that they have had psoriasis since childhood, you might want to assess them," he said.