{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:08:56Z","timestamp":1775470136044,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T00:00:00Z","timestamp":1574121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/L011808\/1"],"award-info":[{"award-number":["MR\/L011808\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The cardiovascular safety profile of biologic therapies used for psoriasis is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the risk of major cardiovascular events (<jats:styled-content style=\"fixed-case\">CVE<\/jats:styled-content>s; acute coronary syndrome, unstable angina, myocardial infarction and stroke) in patients with chronic plaque psoriasis treated with adalimumab, etanercept or ustekinumab in a large prospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective cohort study examining the comparative risk of major <jats:styled-content style=\"fixed-case\">CVE<\/jats:styled-content>s was conducted using the British Association of Dermatologists Biologics and Immunomodulators Register. The main analysis compared adults with chronic plaque psoriasis receiving ustekinumab with tumour necrosis\u2010\u03b1 inhibitors (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i: etanercept and adalimumab), whilst the secondary analyses compared ustekinumab, etanercept or methotrexate against adalimumab. Hazard ratios (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>s) with 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s) were calculated using overlap weights by propensity score to balance baseline covariates among comparison groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 5468 biologic\u2010na\u00efve patients subsequently exposed (951 ustekinumab; 1313 etanercept; and 3204 adalimumab) in the main analysis. The secondary analyses also included 2189 patients receiving methotrexate. The median (p25\u2013p75) follow\u2010up times for patients using ustekinumab, <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i, adalimumab, etanercept and methotrexate were as follows: 2.01 (1.16\u20133.21), 1.93 (1.05\u20133.34), 1.94 (1.09\u20133.32), 1.92 (0.93\u20133.45) and 1.43 (0.84\u20132.53) years, respectively. Ustekinumab, <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i, adalimumab, etanercept and methotrexate groups had 7, 29, 23, 6 and 9 patients experiencing major <jats:styled-content style=\"fixed-case\">CVE<\/jats:styled-content>s, respectively. No differences in the risk of major <jats:styled-content style=\"fixed-case\">CVE<\/jats:styled-content>s were observed between biologic therapies [adjusted <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> for ustekinumab vs. <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i: 0.96 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.41\u20132.22); ustekinumab vs. adalimumab: 0.81 (0.30\u20132.17); etanercept vs. adalimumab: 0.81 (0.28\u20132.30)] and methotrexate against adalimumab [1.05 (0.34\u20133.28)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large prospective cohort study, we found no significant differences in the risk of major <jats:styled-content style=\"fixed-case\">CVE<\/jats:styled-content>s between three different biologic therapies and methotrexate. Additional studies, with longer term follow\u2010up, are needed to investigate the potential effects of biologic therapies on incidence of major <jats:styled-content style=\"fixed-case\">CVE<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16018","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T14:40:47Z","timestamp":1571668847000},"page":"769-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Risk of major cardiovascular events in patients with psoriasis receiving biologic therapies: a prospective cohort study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8393-5781","authenticated-orcid":false,"given":"W.","family":"Rungapiromnan","sequence":"first","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety School of Health Sciences Faculty of Biology, Medicine and Health University of Manchester 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