BIOLOGIC therapies significantly reduce the risk of major adverse cardiovascular events (MACEs) in patients with psoriasis and psoriatic arthritis (PsA), offering potential heart health benefits beyond skin and joint relief. This is according to the results of a new retrospective cohort study. The study, published using Korean health insurance data from 2008 to 2021, analyzed over 183,000 patients and nearly 260,000 treatment episodes.
Researchers found that patients treated with biologic therapies had a substantially lower risk of both new-onset and recurrent MACEs—including heart attack, stroke, cardiac arrest, unstable angina, and heart failure—compared to those receiving phototherapy. The adjusted hazard ratio (HR) for new-onset MACEs in biologic-treated patients was 0.454 (95% CI, 0.359-0.574), and for recurrent events, the HR was 0.343 (95% CI, 0.245-0.479).
Nonbiologic systemic therapies also showed a reduced risk of recurrent MACEs compared to phototherapy but only in patients with a prior history of cardiovascular events (adjusted HR, 0.789; 95% CI, 0.658-0.946).
These findings provide crucial insights for dermatologists, rheumatologists, and cardiologists managing psoriasis and PsA patients, particularly those with preexisting cardiovascular conditions. Given that psoriasis and PsA are known to increase cardiovascular risk, this study reinforces the potential dual benefit of biologic therapies in both managing inflammatory disease and reducing heart complications.
However, the study authors caution that its observational design limits causal inference, and residual confounding may be present. More research is needed to further establish the cardiovascular protective effects of biologic therapies.
For healthcare professionals treating psoriasis and PsA, this study highlights the importance of considering cardiovascular risk when selecting systemic therapies. Biologics may offer a safer and more effective option for patients at risk of cardiovascular disease, potentially changing the landscape of psoriasis treatment strategies.
Reference: Song WJ et al. Association between biologic and nonbiologic systemic therapy for psoriasis and psoriatic arthritis and the risk of new-onset and recurrent major adverse cardiovascular events: A retrospective cohort study. J Am Acad Dermatol. 2025:S0190-9622(25)00524-9.
Anaya Malik | AMJ
