One group of study patients took TNF blockers etanercept (Enbrel), infliximab (Remicade) or adalimumab (Humira).
Other patients randomly assigned to a second group received either oral medicines -- cyclosporine, acitretin or methotrexate -- or phototherapy. The third group received topical medications alone.
TNF blockers have changed the treatment of psoriasis and other inflammatory diseases such as rheumatoid arthritis, but they do have their share of side effects including infection and certain types of cancer. "In psoriasis, the immune system is hyperactive so we try to reduce it, but anytime you lower immune activity, there is always the risk of infection or reactivation of a latent infection," Wu said.
Not everyone with psoriasis does or should take biologic medications. "I usually determine the severity of the psoriasis first," he said. "If 10 percent of their body is covered or if they have psoriatic arthritis and/or have failed other medications, they are eligible," he said.
These drugs are not inexpensive; a November 2011 study in Arthritis & Rheumatism found that for patients taking various TNF drugs for psoriatic arthritis, costs ranged from about $13,500 to nearly $25,000 per year.
The study findings are welcome news, said Dr. Bruce Strober, an associate professor of dermatology at the University of Connecticut in Farmington.
"There is previous and well-replicated evidence that patients with [rheumatoid arthritis] treated successfully with TNF inhibitors demonstrate a lowered risk of heart attack, and perhaps even heart failure. But similar data in psoriasis have been lacking," he said. "This analysis is the first demonstration that, potentially, the use of TNF inhibitors may prevent heart attacks in psoriasis patients."
Still, Strober said, "these data must be viewed as preliminary and not conclusive, as more studies from different source databases must replicate and confirm these findin
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