Impact of Secukinumab on Endothelial Dysfunction and Other Cardiovascular Disease Parameters in Psoriasis Patients over 52 Weeks.

Abstract

Psoriasis increases the risk of cardiovascular (CV) disease. Secukinumab, a fully human monoclonal antibody against IL-17A, shows significant efficacy in psoriasis, but effects on CV markers are unknown. CARIMA (Evaluation of Cardiovascular Risk Markers in Psoriasis Patients Treated with Secukinumab) was a 52-week, randomized, double-blind, placebo-controlled, exploratory trial in patients with moderate to severe plaque psoriasis without clinical CV disease. Patients were randomly assigned to receive 300 mg or 150 mg secukinumab until week 52 or to receive placebo until week 12 and then 300 mg or 150 mg secukinumab until week 52. The primary outcome was endothelial function measured by flow-mediated dilation (FMD). Baseline FMD was significantly lower in psoriasis patients than healthy volunteers (4.4 ± 3.9% vs. 6.1 ± 3.3%, P = 0.01). At week 12, baseline-adjusted mean FMD was numerically higher in patients receiving secukinumab versus those receiving placebo, but this difference (300-mg group, +1.2%; 150-mg group, +0.76%; P = 0.223 and P = 0.403 by analysis of covariance) did not reach significance. At week 52, FMD increased across groups. FMD was significantly higher than baseline in patients receiving the label dose of 300 mg secukinumab for 52 weeks (+2.1%, 95% confidence interval = 0.8-3.3; P = 0.0022). Other relevant CV markers were unchanged. CARIMA indicates that secukinumab might have a beneficial effect on CV risk by improving the endothelial function of patients with plaque psoriasis.

• Authors: Esther von Stebut, Kristian Reich, Diamant Thaçi, Wolfgang Koenig, Andreas Pinter, Andreas Körber, Tienush Rassaf, Ari Waisman, Venkatesh Mani, Denise Yates, Jennifer Frueh, Christian Sieder, Nima Melzer, Nehal N Mehta, Tommaso Gori
• Journal: The Journal of investigative dermatology (J Invest Dermatol) Vol. 139 Issue 5 Pg. 1054-1062 (05 2019) ISSN: 1523-1747 [Electronic] United States
• PMID: 30508547 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Monoclonal, Humanized
• Biomarkers
• secukinumab

Topics

• Adult
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Biomarkers (blood)
• Cardiovascular Diseases (epidemiology, prevention & control)
• Comorbidity
• Dose-Response Relationship, Drug
• Double-Blind Method
• Drug Administration Schedule
• Endothelium, Vascular (drug effects)
• Female
• Humans
• Male
• Middle Aged
• Prognosis
• Psoriasis (diagnosis, drug therapy, epidemiology)
• Reference Values
• Regional Blood Flow (drug effects)
• Risk Assessment
• Severity of Illness Index
• Treatment Outcome