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Ustekinumab also reduces aortic vascular inflammation

Ustekinumab may be an effective agent to lessen aortic inflammation, a key marker that can indicate a patient’s propensity for major cardiovascular events, according to a study presented at the 2018 American Academy of Dermatology Annual Meeting in San Diego on February 17.

“The type of inflammation we see in psoriasis is similar to what we see in atherosclerosis—a type of heart disease that involves the build-up of fats, cholesterol, and inflammatory cells in the artery walls,” said Dr. Joel M. Gelfand, senior author and professor of dermatology and epidemiology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, in a press release. “Since ustekinumab blocks the specific pathways involved in both skin and cardiovascular inflammation, we wanted to test whether it can improve aortic vascular inflammation.”

From left to right: clinical image of psoriasis, scanning PET image of psoriasis in the skin, with darker red zones indicating greater inflammation, and scanning PET image demonstrating signal of inflammation in the arterial vessels. Photo courtesy of the Perelman School of Medicine at the University of Pennsylvania.

Researchers divided patients with psoriasis into two experimental arms—–21 patients were assigned to the placebo group while 22 patients received ustekinumab treatment. To measure aortic inflammation, imaging through fludeoxyglucose positron emission tomography (18-FDG-PET) and computed tomography (CT) scans were conducted before treatment and 12 weeks post-treatment.

The study was funded by Janssen Scientific Affairs, LLC, which manufactures ustekinumab. The National Institutes of Health in the U.S. provided additional financial support.

Participants who received ustekinumab experienced a 6.6% decrease in aortic inflammation, while a 12% increase was seen in the placebo group. Therefore, the treatment is responsible for a 19% improvement relative to untreated patients, the researchers calculated.

As expected, ustekinumab also lessened skin inflammation, with 77% of patients achieving a 75% or better improvement in their Psoriasis Area and Severity Index (PASI), compared to just 10.5% in the placebo group.

“This is the first placebo-controlled trial of a biologic drug to show a benefit in aortic inflammation, a key marker of cardiovascular disease,” said Dr. Gelfand. “The effect is similar to what we would expect if we put the patient on a statin.”

In order to confirm their findings, Dr. Gelfand and his colleagues had their imaging data evaluated by a second, separate lab.

The researchers plan on extending their study, to assess if the benefits of the treatment are long-term and sustainable.

“This study represents promise that this treatment may reduce the risk of heart attack and stroke in the future. It’s an encouraging finding,” said Dr. Gelfand.

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