For patients with moderate-to-severe psoriasis, the perivascular fat attenuation index (FAI), as measured by coronary computed tomography angiography (CCTA), indicates reduced coronary inflammation in association with biologic therapy, according to a study published online July 31 in JAMA Cardiology.

Youssef A. Elnabawi, M.D., from the National Institutes of Health in Bethesda, Maryland, and colleagues used perivascular FAI to examine the correlation between biologic therapy and coronary inflammation in 134 patients with moderate-to-severe psoriasis, most with low cardiovascular risk by traditional risk scores. Of the patients, 82 received biologic psoriasis therapy for one year and 52 were given topical or light therapy (control group).

The researchers found that 46 patients (27 in the treated group and 19 in the control group) had focal coronary atherosclerotic plaque at baseline. Biologic therapy correlated with a significant decrease in FAI at one year (median FAI, −71 22 Hounsfield units [HU] at baseline versus −76.09 HU at one year), with concurrent improvement in skin disease (median Psoriasis Area Severity Index, 7.7 at baseline versus 3.2 at one year); those not receiving biologic therapy had no change in FAI (median FAI, −71.98 HU versus −72.66 HU). The correlations with FAI were independent of coronary plaque and were consistent for patients receiving different biologic agents.

"Our study was the first, to our knowledge, to introduce FAI as a biomarker of coronary inflammation that enables tracking of response to anti-inflammatory treatments in the human coronaries," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry; several authors reported having patents, including one for a novel tool for cardiovascular risk stratification.

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