Cardiovascular risk in psoriasis: Implications for your clinical practice Joel M Gelfand, MD, MSCE Medical Director, Clinical Studies Unit Associate Professor of Dermatology and Epidemiology Senior Scholar, Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine University of Pennsylvania
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Cardiovascular risk in psoriasis:
Implications for your clinical
practice
Joel M Gelfand, MD, MSCE Medical Director, Clinical Studies Unit
Associate Professor of Dermatology and Epidemiology
Senior Scholar, Center for Clinical Epidemiology
and Biostatistics
Perelman School of Medicine
University of Pennsylvania
Disclosure statement
• I have been an investigator and/or consultant for
Amgen, Abbvie, Jansen, Merck (DSMB), Pfizer,
Lilly, Celgene, Coherus (DSMB), and Novartis
• This presentation is the sole work of Dr. Gelfand
disease: Mechanistic insights Metabolic and CV gene
expression > cycle and
inflammatory disease
categories in lesional vs non
lesional psoriasis biopsies
KC-Tie2 psoriasis skin
specific inflammation mouse
model demonstrates
development of aortic
inflammation and thrombosis
Wang Y, Gao H, Loyd CM, Fu W, Diaconu D, Liu S, Cooper KD, McCormick TS, Simon DI, Ward NL Chronic skin-specific inflammation promotes vascular inflammation and thrombosis J
Invest Dermatol. 2012 Aug;132(8):2067-75.
Suárez-Fariñas M, Li K, Fuentes-Duculan J, Hayden K, Brodmerkel C, Krueger JG. Expanding the psoriasis disease profile: interrogation of the skin and serum of patients with moderate-to-
severe psoriasis. J Invest Dermatol. 2012 Nov;132(11):2552-64.
Psoriasis is more than skin deep: results
from advanced FDG-PET/CT Imaging
• Psoriasis is associated with
increased vascular
inflammation independent of
traditional risk factors and
equivalent to 10 years of
aging
• Subclinical inflammation in
liver and joints
FDG-PET/CT: A reliable, dynamic and responsive
surrogate marker of cardiovascular risk
• FDG-PET measurement of
vascular inflammation is:
1. A marker of CD68+ macrophage
metabolic activity
2. Reliable
3. Predictive of future CV events
4. Responsive to CV risk factor
modification
• Psoriasis patients demonstrate
vascular inflammation equivalent
to 1 decade of aging > than
controls
Rudd et al. J Am Coll Cardiol. 2007 Aug 28;50(9):892-6 Tahara et al. J Am Coll Cardiol. 2006 Nov 7;48(9):1825-31. Rudd et al. Circulation. 2002 Jun 11;105(23):2708-11. Alavi et al. Clin Nucl Med. 2001 Apr;26(4):314-9 Lee et al. J Nucl Med. 2008 Aug;49(8):1277-82 Rominger et al. J Nucl Med. 2009 Oct;50(10):1611-20. Arauz et al. Clin Neurol Neurosurg. 2007 Jun;109(5):409-12. Mehta NN et al. Arch Derm 2011;147:1031-9.
Friedewald VE, et al. Am J Cardiol. 2008 Dec 15; 102(12):1631-43.
Kimball AB, et al. J Am Acad Dermatol. 2008 Jun;58(6):1031-42.