Work

The Impact of Targeted Therapies on the Bone-Vascular Axis in Psoriasis: A Narrative Review

Year: 2026

Type: review

Abstract: This narrative review elucidates the impact of biologics and small-molecule inhibitors on bone metabolism and cardiovascular risk in patients with psoriasis. Psoriasis is a systemic immune-mediated disorder characterized by a "Calcification Paradox"-the simultaneous occurrence of skeletal bone loss and vascular calcification. We explore the molecular mechanisms of the "Bone-Vascular Axis", highlighting how the IL-23/IL-17 axis disrupts the RANKL/OPG balance and drives the osteogenic transdifferentiation of vascular smooth muscle cells. We critically evaluate the therapeutic impact of targeted agents, noting that IL-23 and dual IL-17A/F inhibitors offer significant structural protection in psoriatic arthritis. Regarding oral therapies, while JAK inhibitors necessitate cardiovascular risk stratification, the novel TYK2 inhibitor deucravacitinib demonstrates a favorable cardiovascular safety profile based on long-term extension data, although large-scale, hard endpoint-driven cardiovascular outcome trials (CVOTs) remain necessary to confirm definitive long-term protection. We conclude that effective management must shift from skin-focused control to a comprehensive systemic strategy targeting the bone-vascular axis to mitigate long-term comorbidities.

Source: Clinical Cosmetic and Investigational Dermatology

DOI: 10.2147/ccid.s595065

Authors: Huimei Zeng, Yourui Chen, Langhuan Yang

Institution: Yunnan University of Traditional Chinese Medicine

Language: English

Topic: Psoriasis: Treatment and Pathogenesis

Subfield: Immunology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836