Humira v Fumaric Acid Esters on cardiovascular disease in psoriasis

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This study compared Humira (adalimumab) and Fumaric Acid Esters (FAE) on cardiovascular disease markers in psoriasis patients.

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Background:
The effect of adalimumab and fumaric acid esters (FAE) on the cardiovascular risk associated with psoriasis has only been investigated scarcely in randomized controlled studies.

Objective:
The aim of this prospective, randomized controlled head‐to‐head trial was to compare the influence of adalimumab and FAE on cardiovascular disease markers in psoriasis patients.

Methods:
65 patients with moderate to severe plaque psoriasis were randomly assigned to adalimumab or FAE treatment for 6 months. Cardiovascular hemodynamic parameters (flow mediated dilation (FMD), nitro‐glycerine mediated dilation (NMD) and carotid intima media thickness (CIMT), blood pressure) were assessed at baseline(v0) and after 6 months(v6). Cutaneous disease severity, inflammatory and lipid cardiovascular risk markers were analysed at baseline(v0), after three(v3) and six months(v6).

Results:
After 6 months of treatment FMD in the adalimumab group increased significantly (v0 5,9% (6,4% S.D), v6 8,0% (4,8% S.D.), p=0,048) but not in the FAE group. (v0 7,0% (4,1% S.D), v6 8,4% (6,1% S.D.), p=0,753) This was paralleled by a significant decrease of hsCRP in the adalimumab group in comparison to the FAE group (v0: 0,39 mg/dl (0,38 S.D.), v6: 0,39mg/dl (0,48 S.D.), p=0,043). No significant changes were observed in any other hemodynamic parameters. FAE, however, additionally decreased total cholesterol (p=0,046) and apolipoprotein B (p=0,041) levels compared to adalimumab. Mean PASI (psoriasis area severity score) reduction was greater but not significant (p=0,116) under adalimumab treatment compared to FAE treatment ( ‐71,1% (29,9 S.D) vs. ‐54,6% (45,7%)).

Conclusion:
In our study both treatments were documented to exert effects on the cardiovascular system. While adalimumab showed anti‐inflammatory effects and improved FMD, FAE interacted favourably with the cholesterol metabolism.

Source: onlinelibrary.wiley.com

*Early view funding unknown

Humira (adalimumab)

Dimethylfumarates and Psoriasis