Cardiovascular and Kidney Outcomes After Systemic Treatment for Plaque Psoriasis: A Systematic Review and Network Meta-analysis.

IF 4.2 3区医学 Q1 DERMATOLOGY

Dermatology and Therapy Pub Date : 2025-07-05 DOI:10.1007/s13555-025-01472-5

Ao Shi, Yuan Shu, Joe El Haddad, Shuqin Wu, Karen Smayra, Shivon Mirza Sudesh, Mohammed Majd Mourad, Armin Farzad, Nathanael Yap, Efstathia Andrikopoulou, Qi Liu, Pengyang Li, Ying Tu

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引用次数: 0

Abstract

Introduction: Systemic immunomodulatory treatments may affect cardiovascular and renal outcomes in patients with chronic plaque psoriasis. We conducted a network meta-analysis (NMA) to compare these outcomes of systemic treatments for plaque psoriasis.

Methods: Databases were searched from inception through June 1, 2023. We conducted duplicate study selection, data extraction, bias assessment risk, and NMA evidence certainty assessment and analyses. Outcomes included proportion of participants achieving Psoriasis Area and Severity Index (PASI) 75 and/or 90 and those with (1) total cardiovascular events, (2) major adverse cardiovascular events (MACE), (3) other cardiovascular events, and (4) total renal events.

Results: We included 68 randomized clinical trials (n = 34,414 patients). Compared with placebo, bimekizumab (odds ratio [OR] 101.12, 95% confidence interval [CI] 34.26-301.46, surface under the cumulative ranking curve [SUCRA] 27, high certainty) was the top treatment demonstrating better PASI 75 and had reduced total cardiovascular events (OR 0.06, 95% CI 0-0.80, SUCRA 89, moderate certainty). Ixekizumab (OR 86.92, 95% CI 39.06-199.66, SUCRA 15, high certainty) showed better PASI 90 rates but was associated with increased MACE over placebo (OR 3.26, 95% CI 1.26-9.31, SUCRA 26, high certainty) and bimekizumab (OR 31.92, 95% CI 2.01, 1123.25), moderate certainty). Renal outcomes were similar among groups.

Conclusion: Bimekizumab showed better therapeutic efficacy scores and safety profile than other agents. Ixekizumab may increase cardiovascular risk and should be used with caution. Reliable long-term safety data of the treatments analyzed here require assessing non-randomized studies and examining postmarketing reports from regulatory agencies.

Trial registration: PROSPERO (CRD42022381489).

查看原文本刊更多论文

斑块型银屑病全身治疗后的心血管和肾脏预后：系统综述和网络荟萃分析。

系统性免疫调节治疗可能影响慢性斑块型银屑病患者的心血管和肾脏预后。我们进行了一项网络荟萃分析（NMA）来比较斑块型银屑病全身治疗的这些结果。方法：检索自成立至2023年6月1日的数据库。我们进行了重复研究选择、数据提取、偏倚风险评估和NMA证据确定性评估和分析。结果包括银屑病面积和严重程度指数（PASI）达到75和/或90的参与者比例，以及(1)总心血管事件，(2)主要不良心血管事件（MACE），(3)其他心血管事件和(4)总肾脏事件的参与者比例。结果：我们纳入了68项随机临床试验（n = 34,414例患者）。与安慰剂相比，比美珠单抗（优势比[OR] 101.12, 95%可信区间[CI] 34.26-301.46，累积排序曲线下表面[SUCRA] 27，高确定性）是显示更好PASI 75和减少总心血管事件的顶级治疗（OR 0.06, 95% CI 0-0.80, SUCRA 89，中等确定性）。Ixekizumab （OR 86.92, 95% CI 39.06-199.66, SUCRA 15，高确定性）显示出更好的PASI 90率，但与安慰剂（OR 3.26, 95% CI 1.26-9.31, SUCRA 26，高确定性）和比美珠单抗（OR 31.92, 95% CI 2.01, 1123.25）相比，MACE增加相关。各组间肾脏预后相似。结论：比美珠单抗的疗效评分和安全性优于其他药物。Ixekizumab可能增加心血管风险，应谨慎使用。本文分析的可靠的长期安全性数据需要评估非随机研究和检查监管机构的上市后报告。试验注册：PROSPERO （CRD42022381489）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.