Background:
Recent evidence suggests IL-17 contributes to the pathogenesis of autoimmune, inflammatory, and cardiovascular diseases. It has been demonstrated
in vivo
that IL-17 is critical for the maintenance of angiotensin II-induced hypertension (HTN) and vascular dysfunction. We aim to determine if IL-17 inhibitors (IL-17I) have direct effects on blood pressure (BP) in human subjects.
Method:
We conducted a single-center retrospective cohort study of patients who had been treated with an IL-17I (ixekuzumab or secukinumab) for psoriasis (P) or psoriatic arthritis (PA). Aggregated data in a 3 month window at 3-months prior to initiation of the IL-17I (baseline) and at 3, 6, and 12 months after initiation were analyzed using paired t-test. Wilcoxon non-parametric test was used if normality test failed. Pre-existing HTN was defined by ICD-coding. Unique antihypertensive medication was defined as number of unique class of BP prescription filled within a specified 3-month windows.
Results:
We identified 307 patients who had been treated with IL-17I. We included 103 patients who had BP data in all above specified time windows. The mean age was 47 ± 13 years, 39 (38%) were men, 68 (66%) had HTN, and 23 (22%) had diabetes. Among all patients, mean baseline BP was 129/76 mmHg. There was no significant change in systolic or diastolic BP (SBP or DBP, respectively) at 3 months (129/76 mmHg) or 6 months (130/76 mmHg). There was a trend of increased BP at 12 months (131/77 mm Hg), reaching significance only for DBP (p = 0.048). When stratified by pre-existing HTN, there was no significant change in SBP or DBP at any time point. The number of unique prescribed BP medication was 0.45 at baseline, and significantly increased to 0.68 (p= 0.027), 0.87 (p=0.006), and 0.83(p=0.004) at 3-,6-, and 12-month respectively, suggesting patients required more antihypertensive therapy while on IL-17I.
Conclusion:
IL-17I use for P or PA was not associated with a significant change in BP over 1 year of treatment. This could be confounded by an increase in the number of unique BP medications prescribed which implies a rise in BP. This could be due to IL-17I therapy or other factors such as age. A prospective study is needed to better evaluate the effects of IL-17 inhibition on BP.
