A meta-analysis of clinical trials found that the use of tumor necrosis factor (TNF) inhibitors was associated with decreased rates of mortality and reduced incidence of myocardial infarction compared to topical and/or phototherapy in patients with psoriasis and psoriatic arthritis. These results were recently published in Clinical Reviews in Allergy & Immunology.

Psoriasis and psoriatic arthritis have been associated with higher risk of cardiac and cerebrovascular events but whether TNF inhibitors have an effect on reducing cardiovascular (CV) events remains unclear. 

Zheng-sheng Yang, from The First Hospital of Qinhuangdao, China, and colleagues evaluated the effect of TNF inhibitors on adverse cardiovascular events in psoriasis with or without psoriatic arthritis by conducting a meta-analysis of clinical trials. 

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High Yield Data Summary

  • TNF inhibitor use in PsA was associated with a decreased incidence of myocardial infarction vs. topical/photo rmethotrexate treatment

They searched various databases through December 31, 2015 and included a total of 5 studies (n=49 795) for their analysis.

The authors found that TNF inhibitors were associated with a significantly lower risk of cardiovascular events (risk ratio [RR] 0.58, 95% CI: 0.43–0.77; P<.001) vs topical/photo treatment.

When compared with methotrexate, the risk of CV events was also notably lower in the TNF inhibitor group (RR 0.67, 95% CI: 0.52–0.88; P=.003). 

TNF inhibitors were also associated with a decreased incidence of myocardial infarction vs. topical/photo or methotrexate treatment (RR 0.73, 95% CI: 0.59–0.90; P=.003 and RR 0.65, 95% CI: 0.48–0.89; P=.007, respectively). 

Overall, TNF inhibitors appeared to have net clinical benefits with regard to adverse CV events in psoriasis and/or psoriatic arthritis. Further randomized controlled trials are necessary to assess whether TNF inhibitors lead to a reduction in CVD. 


Yang Z, Lin N, Li L, Li Y. Effect of TNF Inhibitors on cardiovascular events in psoriasis and psoriatic arthritis: an Updated meta-analysis. Allergy & Immunology. 2016. Published online ahead of print June 14, 2016. 

This article originally appeared on MPR