Effects of interleukin 17A inhibition on myocardial deformation and vascular function in psoriasis

Abstract Background Interleukin (IL)-17A activity is implicated in psoriasis. We investigated the effects of IL-17A inhibition on vascular and left ventricular (LV) function in psoriasis patients. Methods 150 psoriasis patients received either an anti-IL-17A agent (secukinumab, n=50), cyclosporine (n=50) or methotrexate treatment (n=50). At baseline and after 4 and 12 months of treatment, we measured (1) LV global longitudinal strain (GLS), strain rate (GLSR), strain rate at early diastole (GLSRE), LV twisting (LVtwist) and untwisting (2) coronary flow reserve (CFR), (3) pulse wave velocity (PWV), (4) malondialdehyde (MDA) and protein carbonyl (PC) as markers of oxidative stress. Results Compared to cyclosporine and methotrexate, anti-IL-17A treatment resulted in greater increase in GLS at 4 and 12 months post-treatment (10% and 14% with anti-IL-17A vs. 2% and 2% with cyclosporine vs. 4% and 4% with methotrexate respectively), GLSR, GLSRE (45% and 41% vs. 5% and 4% vs. 7% and 9% respectively) and LV twist (32% and 28% vs. 6% and 8% vs. 7% and 6% respectively) (P Conclusions In psoriasis, inhibition of IL-17A results in a greater improvement of vascular and myocardial function compared with cyclosporine or methotrexate treatment, indicating a beneficial effect on overall cardiovascular function.