TOPLINE:

Patients with psoriatic arthritis (PsA) treated with biologics had lower rates of cardiovascular events and all-cause and cardiovascular mortality but a higher risk for infection-related admissions than those treated with conventional disease-modifying antirheumatic drugs (cDMARDs) in a new retrospective cohort study.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from an electronic medical records database in Taiwan to examine the cardiovascular effects of systemic treatments for PsA in Asian patients.
• They identified 2383 patients with PsA who had used at least one DMARD and divided them into two groups: 1190 patients received biologic DMARDs (bDMARDs), and 1193 patients received cDMARDs.
• The average follow-up duration was around 5 years.
• Primary outcome measures included major adverse cardiovascular events, including stroke, myocardial infarction, cardiovascular mortality, and coronary revascularization; secondary outcomes included all-cause mortality, cardiovascular mortality, infection-related admissions, newly diagnosed diabetes, and newly diagnosed malignancies.

TAKEAWAY:

• The incidence of major adverse cardiovascular events was significantly lower in the bDMARD group than in the cDMARD group (hazard ratio [HR], 0.65; P = .032).
• Patients in the bDMARD group also had lower risks for all-cause mortality (HR, 0.44; P < .001) and cardiovascular mortality (HR, 0.54; P = .023) than those in the cDMARD group.
• However, the risk for infection-related admissions was significantly increased in patients who received bDMARDs vs cDMARDs (subdistribution HR, 1.45; P < .001).
• The protective effect of bDMARDs against major adverse cardiovascular events and mortality outcomes was more pronounced in younger patients and those without alcohol consumption.

IN PRACTICE:

“bDMARDs may provide additional benefits, indicating that aggressive PsA treatment with bDMARDs could be advantageous,” the authors wrote.

SOURCE:

The study was led by Chung-Yuan Hsu, MD, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. It was published online on October 13, 2025, in Rheumatology.

LIMITATIONS:

This database study had limitations, including an inadequate follow-up period and absence of disease activity assessments. The median follow-up of approximately 5 years may be insufficient to capture long-term cardiovascular outcomes such as progressive atherosclerosis. Additionally, the absence of standardized disease activity measures could introduce bias by obscuring the true relationship between inflammatory burden and cardiovascular risk. 

DISCLOSURES:

This study was supported by grants from the Chang Gung Medical Research Foundation, Taiwan. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.