Arterial stiffness in patients with moderate to severe psoriasis on long term treatment with infliximab

BACKGROUND: Systemic anti-inflammatory therapies reduce arterial stiffness during short term treatment in patients with psoriasis, but less is known about their long-term effects. We assessed arterial stiffness in patients with psoriasis on long-term treatment with infliximab. METHODS: Forty-eight patients with psoriasis (age 46 ± 14 years, 31% women) receiving treatment with infliximab were matched to 103 controls based on age, sex and body mass index (BMI). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Psoriasis severity was assessed by the psoriasis area and severity index (PASI). RESULTS: The patients had been treated with infliximab for 4.9 ± 3.9 years and 85% were also treated with methotrexate. Current PASI-score was 0.79 ± 0.75, indicating well treated psoriasis. The prevalence of metabolic syndrome (42%), hypertension (50%) and diabetes (4%) were similar between patients and controls, while a higher proportion of patients were smokers (40% vs. 16%, p = 0.003). Average cfPWV was 7.9 ± 1.6 m/s in the psoriasis group and 7.3 ± 1.5 m/s in the control group (p = 0.049), both reflecting normal values. In multivariable linear regression analysis in the total study population, having psoriasis remained associated with higher cfPWV (β 0.40, p = 0.010) after adjusting for age, sex, systolic blood pressure (SBP), heart rate, BMI and smoking. In patients with psoriasis, higher SBP (β 0.33, p = 0.009) and BMI (β 0.27, p = 0.021) were associated with higher cfPWV after adjustment for PASI score, age and sex. CONCLUSION: In patients with psoriasis on long-term treatment with systemic therapies, arterial stiffness was slightly higher than in matched controls, despite excellent response to treatment and low PASI score.