The Impact of Treatment with IL-17/IL-23 Inhibitors on Subclinical Atherosclerosis in Patients with Plaque Psoriasis and/or Psoriatic Arthritis: A Systematic Review

Accumulating evidence considers psoriasis a systemic inflammatory disorder that is associated with comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Although the precise pathogenetic links between psoriasis and atherosclerosis warrants further investigation, it is believed that chronic systemic inflammation along with the T helper (Th)-1 and Th17 polarization are associated with endothelial dysfunction and subsequent acceleration of atherosclerosis. Considering the above, several studies have evaluated if optimal control of the inflammation in psoriasis by inhibiting interleukins targeting the Interleukin (IL)-23/Th17 axis could subsequently reduce the atherosclerotic process during anti-psoriatic treatment by using a variety of surrogate markers of subclinical atherosclerosis. This systematic review summarizes current knowledge on the pathogenetic mechanisms and diagnostic evaluation of atherosclerosis in the context of psoriasis and provides a systematic review of the literature on the impact of treatment with biologics targeting the IL-23/Th17 axis on subclinical atherosclerosis in patients with plaque psoriasis and/or psoriatic arthritis.

Automated summary

Accumulating evidence suggests that psoriasis, a systemic inflammatory disorder, is associated with comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Chronic systemic inflammation and T helper (Th)-1 and Th17 polarization are believed to be associated with endothelial dysfunction and accelerated atherosclerosis. This systematic review summarizes the current understanding of the pathogenesis and diagnostic evaluation of atherosclerosis in psoriasis, and reviews the impact of IL-23/Th17 axis-targeted biologic treatments on subclinical atherosclerosis in patients with psoriasis and/or psoriatic arthritis.