18F-fluorodeoxyglucose positron emission tomography-based evaluation of systemic and vascular inflammation and assessment of the effect of systemic treatment on inflammation in patients with moderate-to-severe psoriasis: A randomized placebo-controlled pilot study

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dc.contributor.authorKaur, Sharonjeeten_US
dc.contributor.authorShafiq, Nusraten_US
dc.contributor.authorDogra, Sunilen_US
dc.contributor.authorMittal, BRen_US
dc.contributor.authorAttri, Savita Vermaen_US
dc.contributor.authorBahl, Ajayen_US
dc.contributor.authorNarang, Tarunen_US
dc.contributor.authorVinay, Keshavamurthyen_US
dc.contributor.authorRajagopalan, Sujiten_US
dc.contributor.authorMalhotra, Samiren_US
dc.date.accessioned2020-01-02T06:51:34Z
dc.date.available2020-01-02T06:51:34Z
dc.date.issued2018-11
dc.description.abstractBackground: Psoriasis is a systemic inflammatory disorder associated with an increased risk of cardiovascular disease. Objective: To evaluate the utility of [[18]F]-fluorodeoxyglucose positron emission tomography/computed tomography in identifying vascular and systemic inflammation in psoriasis patients with moderate-to-severe disease and to analyze its usefulness in assessing the effect of systemic treatment. Methods: This was a randomized, double-blind pilot study conducted in a tertiary care center. Baseline standardized uptake value score was estimated by18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with moderate-to-severe psoriasis and compared with historical controls. Patients were then randomized using computer-generated randomization list into methotrexate or placebo (with or without pioglitazone) groups.18F-fluorodeoxyglucose positron emission tomography/computed tomography was repeated at 12 weeks and composite standardized uptake value score determined. The correlation between Psoriasis Activity and Severity Index and SUVmax was assessed. Results: A total of 16 patients were randomized to different treatment groups. Significant increase in mean SUVmax was observed in the ascending aorta in psoriasis patients as compared to historical controls (2.03 ± 0.53 vs 1.51 ± 0.36, P < 0.03). There was no difference in composite standardized uptake value score after 12 weeks of treatment in any of the treatment groups (P = 0.82), although an improvement in Psoriasis Activity and Severity Index score in the methotrexate arm was observed. No correlation was found between mean SUVmax and Psoriasis Activity and Severity Index scores in various aortic segments (r = 0.3–0.7). Limitations: Small sample size, short follow-up, historical controls, exclusion of patients with comorbid conditions and lack of surrogate markers of systemic inflammation. Conclusion: 18F-fluorodeoxyglucose positron emission tomography imaging showed higher vascular inflammation in ascending aorta of psoriasis patients as compared to historical controls. Systemic treatment with methotrexate and pioglitazone did not influence the vascular inflammation in the short term.en_US
dc.identifier.affiliationsDepartment of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Pediatrics Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.affiliationsDepartment of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiaen_US
dc.identifier.citationKaur Sharonjeet, Shafiq Nusrat, Dogra Sunil, Mittal BR, Attri Savita Verma, Bahl Ajay, Narang Tarun, Vinay Keshavamurthy, Rajagopalan Sujit, Malhotra Samir. 18F-fluorodeoxyglucose positron emission tomography-based evaluation of systemic and vascular inflammation and assessment of the effect of systemic treatment on inflammation in patients with moderate-to-severe psoriasis: A randomized placebo-controlled pilot study. Indian Journal of Dermatology, Venereology and Leprology. 2018 Nov; 84(6): 660-666en_US
dc.identifier.issn0378-6323
dc.identifier.issn0973-3922
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/192430
dc.languageenen_US
dc.publisherIndian Association of Dermatologists, Venereologists & Leprologistsen_US
dc.relation.issuenumber6en_US
dc.relation.volume84en_US
dc.source.urihttps://dx.doi.org/10.4103/ijdvl.IJDVL_717_17en_US
dc.subjectAtherosclerosisen_US
dc.subjectfluorodeoxyglucose positron emission tomography/computed tomographyen_US
dc.subjectmaximum standardized uptake valueen_US
dc.subjectpsoriasisen_US
dc.subjectsystemic inflammationen_US
dc.title18F-fluorodeoxyglucose positron emission tomography-based evaluation of systemic and vascular inflammation and assessment of the effect of systemic treatment on inflammation in patients with moderate-to-severe psoriasis: A randomized placebo-controlled pilot studyen_US
dc.typeJournal Articleen_US
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