Ustekinumab treatment is associated with decreased systemic and vascular inflammation in patients with moderate-to-severe psoriasis: Feasibility study using 18F-fluorodeoxyglucose PET/CT

Background: Evidence suggests that psoriasis might be associated with metabolic syndrome and an increased risk for cardiovascular disease. Objective: To determine whether ustekinumab reduces systemic and vascular inflammation associated with metabolic syndrome and cardiovascular disease, measured using F-18-fluorodeoxyglucose positron emission tomography-computed tomography (F-18-FDG PET/CT). Methods: Patients with psoriasis and healthy controls underwent baseline F-18-FDG PET/CT imaging. Patients with moderate-to-severe psoriasis were treated with ustekinumab and underwent F-18-FDG PET/CT again after a Psoriasis Area and Severity Index of 75 was achieved. Results: After a Psoriasis Area and Severity Index of 75 was achieved with ustekinumab treatment, standardized uptake values were reduced in the liver, spleen, and 5 parts of the aorta (P < .05). Limitations: Our study does not provide outcome data concerning cardiovascular events or metabolic syndrome; it only shows surrogate markers in a limited (Korean) population. Conclusion: Ustekinumab treatment was significantly associated with decreased systemic and vascular inflammation related to metabolic syndrome and cardiovascular disease among patients with psoriasis.