Risk of major adverse cardiovascular events and all-cause mortality among patients with psoriatic disease treated with tumor necrosis factor-α and interleukin-12/23 inhibitors: a nationwide population-based cohort study in Korea

Figures & data

Figure 1. Study flowchart. MACEs: major adverse cardiovascular events; NHIS: national health insurance service; TNF: tumor necrosis factor.

Table 1. Patient demographics.

	TNF-α inhibitor user (n = 899)		lnterleukin-12/23 inhibitor user (n = 1987)
	N	(%)	N	(%)	p Value
Psoriasis duration before biologics initiation (years), mean ± SD	6.99	± 4.54	7.85	± 4.21	<0.001
Min, max	0.00	15.7	0.00	15.5	–
Median [IQR]	6.9	[2.7–11.1]	8.6	[4.3–11.3]	–
Type of psoriatic disease
Psoriasis	786	(87.43)	1766	(88.88)	0.260
Psoriatic arthritis	113	(12.57)	221	(11.12)	–
Age (years), mean ± SD	46.03	± 12.68	46.66	± 12.59	0.210
Sex
Male	570	(63.40)	1360	(68.44)	0.008
Female	329	(36.60)	627	(31.56)	–
Health insurance type
Health insurance	855	(95.11)	1903	(95.77)	0.420
Medical aids	44	(4.89)	84	(4.23)	–
Comorbidities
Hypertension	207	(23.03)	480	(24.16)	0.509
Diabetes	122	(13.57)	284	(14.29)	0.605
Dyslipidemia	459	(51.06)	844	(42.48)	<.001
COPD	9	(1.00)	10	(0.50)	0.126
Liver cirrhosis	8	(0.89)	15	(0.75)	0.706
Chronic kidney disease	10	(1.11)	16	(0.81)	0.419
Heart failure	6	(0.67)	11	(0.55)	0.711
Alcoholic liver disease	9	(1.00)	26	(1.31)	0.485
BMI (kg/m^2)
<25	345	(38.38)	744	(37.44)	0.500
≥25	297	(33.04)	683	(34.37)	–
Smoking
Non-smoker	275	(30.59)	561	(28.23)	0.204
Ex-smoker	160	(17.80)	352	(17.72)	–
Current smoker	207	(23.03)	514	(25.87)	–
Drinking
Non-drinker	283	(31.48)	600	(30.20)	0.239
Moderate drinker	343	(38.15)	772	(38.85)	–
Heavy drinker	16	(1.78)	55	(2.77)	–

BMI: body mass index; COPD: chronic obstructive pulmonary disorder; IQR: interquartile range; SD: standard deviation; TNF: tumor necrosis factor

Figure 2. Risk of MACEs and all-cause mortality among TNF-α inhibitor users compared with IL-12/23 inhibitor users. CI: confidence interval; IL: interleukin; MACEs: major adverse cardiovascular events; NE: not estimated; TNF: tumor necrosis factor. ^†Adjusted for age, sex, and dyslipidemia.

Figure 3. Risk of MACEs and all-cause mortality among TNF-α inhibitor users compared with IL-12/23 inhibitor users according to sex. CI: confidence interval; IL: interleukin; MACEs: major adverse cardiovascular events; NE: not estimated; TNF: tumor necrosis factor. ^†Adjusted for age.

Figure 4. Risk of MACEs and all-cause mortality among TNF-α inhibitor users compared with IL-12/23 inhibitor users according to age. CI: confidence interval; IL: interleukin; MACEs: major adverse cardiovascular events; NE: not estimated; TNF: tumor necrosis factor. ^†Adjusted for sex.

Data sharing statement

Raw data were generated and stored at the National Health Insurance Service and Statistics Korea. Derived data supporting the findings of this study are available from the corresponding authors SE Chang and JM Jung on request.