Psoriasis and Cardiovascular Disease: Novel Mechanisms and Evolving Therapeutics.
Psoriasis and Cardiovascular Disease: Novel Mechanisms and Evolving Therapeutics.
复制标题
银屑病和心血管疾病：新的机制和不断发展的治疗。
DOI：
10.1007/s11883-021-00963-y
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发表时间：
2021-09-01
影响因子：
5.8
通讯作者：
Garshick, Michael S.
中科院分区：
文献类型：
--
作者：
Weber, Brittany;Merola, Joseph F.;Husni, M. Elaine;Di Carli, Marcelo;Berger, Jeffrey S.;Garshick, Michael S.
牛皮癣是一种慢性炎症性皮肤病，与无牛皮癣的人相比，与心血管风险增加有关。本综述将涵盖新出现的心血管风险机制，生物疗法靶向的关键途径，以及目前调节银屑病患者心血管风险的疗法证据。最近的科学工作强调了导致这种风险增加的机制，包括血管内皮功能障碍、血小板活化、血脂异常和心脏代谢合并症增加的作用。更新的生物和靶向合成疗法已经改变了银屑病治疗，现在可以实现高临床缓解率和持久的皮肤病控制。流行病学证据表明，许多这些治疗可能会降低银屑病的心血管风险，但缺乏前瞻性干预数据（或混合）。总体而言，目前的数据表明TNF、IL-17 A和IL-12/23 p40抑制剂具有降低心血管风险的积极或中性能力，但目前的证据仍然与抗IL-23/p19和JAK抑制剂相矛盾。需要更多的研究，包括前瞻性队列，更大数量的患者，治疗持续时间和验证的替代结果，以更好地评估生物治疗对银屑病心血管风险的作用。
Psoriasis is a chronic inflammatory skin condition that is associated with increased cardiovascular risk compared to those without psoriasis. This review will cover emerging mechanisms of cardiovascular risk, key pathways targeted with biologic therapies, and the current evidence on therapies to modulate this risk in patients with psoriasis. Recent scientific work has highlighted mechanisms that contribute to this enhanced risk, including the role of vascular endothelial dysfunction, platelet activation, dyslipidemia, and increased cardiometabolic co-morbidities. Newer biologic and targeted synthetic therapies have transformed psoriasis treatment with high rates of clinical remission and durable skin disease control now possible. Epidemiological evidence suggests that many of these therapies may lower cardiovascular risk in psoriasis, although prospective interventional data is lacking (or mixed). Recently, caution has also been raised that some treatments may negatively affect cardiovascular risk Overall, the current data suggests a positive or neutral ability to reduce cardiovascular risk for TNF, IL-17A and IL-12/23p40 inhibitors, but current evidence remains conflicting for anti-IL-23/p19 and JAK inhibitors. More studies that include prospective cohorts, larger number of patients, treatment duration, and validated surrogate outcomes are needed to better evaluate the role of biologic therapies on cardiovascular risk in psoriasis.
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DOI：
10.1016/j.jaad.2015.02.1095
发表时间：
2015-06-01
影响因子：
13.8
作者：
Armstrong, April W.;Guerin, Annie;Mulani, Parvez
通讯作者：
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影响因子：
10.8
作者：
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影响因子：
10.8
作者：
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影响因子：
13.8
作者：
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通讯作者：
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影响因子：
7.3
作者：
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通讯作者：
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