Increased vascular inflammation on PET/CT in psoriasis and the effects of biologic treatment: systematic review and meta-analyses

Purpose This systematic review and meta-analyses evaluate if aortic vascular inflammation is increased in moderate-severe psoriasis compared to a healthy control group and if biologic treatment, compared to placebo, reduces aortic vascular inflammation in moderate-severe psoriasis. Methods The systematic review and meta-analyses were reported following PRISMA guidelines. PubMed and Embase databases were searched on June 16, 2021, for the terms ‘psoriasis’, ‘psoriatic arthritis’, and ‘PET/CT’ or ‘vascular inflammation’. Pooled effect sizes were estimated for vascular inflammation outcome measures using a random-effects model with inverse variance weighting. Results Four studies, with a total of 224 subjects, were included in the quantitative analysis that studied vascular inflammation in psoriasis compared to healthy controls. Pooled results showed significantly increased vascular inflammation in patients with moderate-severe psoriasis at the entire aorta (composite score) and all aortic segments, except for the infrarenal aorta ( p = 0.06). Results of studies assessing treatment effects of different biological agents on vascular inflammation were inconsistent. Conclusion Overall, the evidence reviewed indicate that there is an association between psoriasis and aortic vascular inflammation, but there are insufficient evidence for a beneficial effect of biologic treatment.