AT A GLANCE

A new consensus from the PPACMAN network provides interdisciplinary recommendations to improve cardiovascular risk evaluation in psoriatic disease. Key strategies include routine screening, biomarker use, lifestyle counseling, and early pharmacologic intervention aligned with cardiology guidelines.

Patients with psoriasis (PsO) and psoriatic arthritis (PsA) have a markedly increased risk of cardiovascular (CV) disease, driven by systemic inflammation and a high prevalence of metabolic comorbidities. Yet despite this well-established association, CV risk is often underrecognized and undertreated in clinical practice. In response, the Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN) has released a consensus statement offering actionable recommendations for dermatologists, rheumatologists, and primary care physicians. These include performing baseline CV risk assessments at diagnosis—especially for patients with moderate-to-severe disease or those initiating biologic therapy—and systematically screening for hypertension, diabetes, dyslipidemia, smoking, obesity, and metabolic syndrome.

The consensus also highlights the potential utility of biomarkers such as high-sensitivity C-reactive protein and lipoprotein(a) in refining risk stratification, and recommends that high-risk patients undergo further evaluation with primary care or cardiology referral. Coronary artery calcium scoring and other imaging tools may aid in decision-making for preventive therapy. Lifestyle counseling on diet, physical activity, weight management, and smoking cessation is emphasized as a cornerstone of CV risk reduction. Pharmacologic strategies, including early statin use and GLP-1 receptor agonists, are recommended where appropriate, alongside anti-inflammatory treatments aimed at mitigating systemic disease burden. The guidance also advises caution with NSAIDs, corticosteroids, and JAK inhibitors, given their potential CV implications. By promoting proactive and coordinated care, this framework seeks to reduce the cardiovascular morbidity and mortality associated with psoriatic disease. A new consensus from the PPACMAN network provides interdisciplinary recommendations to improve cardiovascular risk evaluation in psoriatic disease. Key strategies include routine screening, biomarker use, lifestyle counseling, and early pharmacologic intervention aligned with cardiology guidelines.

"Given the controversy with oral JAKi, patients with a high pretest probability of CVD, high CV risk, or those who have had a myocardial infarction or stroke would benefit from early referral to a cardiologist," write the authors. "The cardiologist or cardio-derm/rheumatology specialist can perform a comprehensive cardiovascular history and laboratory evaluation, thereby aiming to identify patients who would benefit from alternative strategies and aggressive CV risk modification."

Reference: Sheth S, Inestroza K, Merola JF, Weber B, Garshick M. Practical Recommendations on Cardiovascular Risk Evaluation in Patients With Psoriasis and Psoriatic Arthritis for Dermatologists, Rheumatologists, and Primary Care Physicians by the Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network. J Psoriasis Psoriatic Arthritis. Published online May 28, 2025. doi:10.1177/24755303251337020