Effects of interleukin-12/23 inhibitors and interleukin-17 inhibitors on myocardial functions in patients with severe psoriasis

Background and Design: Systemic inflammation, which is involved in the pathogenesis of psoriasis, has been associated with the development of systemic diseases such as metabolic syndrome and cardiovascular disease. Without prospective data, the relationship between biological therapies and myocardial function in patients with severe psoriasis remains unclear. This study aimed to evaluate myocardial function changes through various parameters in psoriasis patients undergoing biological therapy for 12 months.
Materials and Methods: Patients were evaluated at the beginning of treatment and after 12 months using transthoracic echocardiography to assess systolic and diastolic heart functions.
Results: A total of 39 patients (20 males, 19 females) with a mean age of 44.28±13.54 years were included. All treatment groups significantly decreased psoriasis activity and severity index scores after 12 months (p<0.001). No significant changes in biochemical metabolic parameters were observed in any groups during the first year of treatment. A significant improvement in left ventricular global strain was observed in the ustekinumab, secukinumab, and ixekizumab groups compared to baseline (p<0.001, p=0.005, and p<0.001, respectively). A significant improvement in the E/e’ ratio was noted in the ustekinumab and ixekizumab groups, but no change was found in the secukinumab group (p=0.017, p=0.010, and p=0.980, respectively).
Conclusion: This study observed improvements in systolic and diastolic cardiac functions in patients with severe psoriasis treated with antiinterleukin- 12/23 (IL-12/23) inhibitors and anti-IL-17 therapies.

Þiddetli psoriazisli hastalarda interlökin-12/23 ve interlökin-17 inhibitörlerinin miyokardiyal fonksiyonlar üzerine etkileri

Amaç: Psoriazis patogenezinde yer alan sistemik enflamasyon; metabolik sendrom, kardiyovasküler hastalýklar gibi birçok sistemik hastalýðýn geliþimi ile iliþkilendirilmiþtir. Prospektif verilerin olmamasýndan dolayý, þiddetli hastalýkta biyolojik tedavilerin miyokard fonksiyonlarýnýn iliþkisi belirsizliðini koruyor. Bu çalýþmanýn amacý, 12 ay boyunca biyolojik tedavi kullanan psoriazis hastalarýnda miyokardiyal fonksiyonlarýn deðiþikliklerini ortaya koymaktýr.
Gereç ve Yöntem: Hastalarda tedavinin baþlangýcýnda ve tedaviden 12 ay sonra transtorasik ekokardiyografi ile kalbin sistolik ve diyastolik fonksiyonlarý deðerlendirildi.
Bulgular: Çalýþmaya yaþ ortalamasý 44,28±13,54 yýl olan 20 erkek, 19 kadýn olmak üzere toplam 39 hasta dahil edildi. On iki aylýk tedavi sonunda tüm tedavi gruplarýnda psoriazis alan ve þiddet indeksi skorunda anlamlý düþüþ vardý (p<0,001). Tedavinin ilk yýlýnda gruplarda biyokimyasal metabolik parametrelerde anlamlý deðiþiklik gözlenmedi. Ustekinumab, secukinumab ve iksekizumab gruplarýnda tedavi sonrasý sol ventrikül global strain deðerinde baþlangýca göre anlamlý iyileþme gözlendi (sýrasýyla; p<0,001, p=0,005 ve p<0,001). Ustekinumab ve iksekizumab gruplarýnda E/e’ oranlarýnda anlamlý iyileþme görülmesine raðmen secukinumab grubunda fark yoktu (sýrasýyla; p=0,017, p=0,010 ve p=0,980).
Sonuç: Þiddetli psoriazisli hastalarda anti-interlökin-12/23 (IL-12/23) inhibitörü ve anti-IL-17 inhibitörleri ile 12 aylýk tedavi sonrasý diyastolik ve sistolik fonksiyon bozukluðu dahil olmak üzere miyokard fonksiyon bozukluðunda iyileþme gözlenmiþtir.