Etanercept and Vascular Function in Psoriasis

Inclusion Criteria

• Male or non-pregant females aged 21-70 years.
• Diagnosis of moderate to severe plaque psoriasis
• Concomitant therapy: Patients will be allowed to be on concomitant therapy with aspirin, statins, thiazide diuretics, calcium antagonists (for treatment - of hypertension), clonidine, or vasodilators. Patients will be on stable medical therapy for at least 3 months before recruitment.

Exclusion Criteria

• Uncontrolled cardiac risk factors (hypertension, hypercholesterolemia, smoking, diabetes)
• Symptomatic coronary or peripheral atherosclerotic vascular disease
• Current anti-TNF therapy with etanercept or infliximab or therapy in the previous 3 months
• Presence of psoriatic plaque or other skin condition on the volar surface of the forearms which may interfere with vascular ultrasonography
• Pregnancy, Breast feeding
• Active substance abuse
• Other inflammatory condition or malignancy
• Renal failure [creatinine > 2.5mg/dL] or liver failure (Liver enzymes > 2x normal)
• Current use of COX-2 inhibitors
• Inability to give informed consent
• Prednisone dosage > 7.5mg/day
• Statins, anti diabetes medications, and aspirin will be continued if the patient is on stable therapy for at least 3 months, and all medications will be continued without alteration of doses during the study period.
• Antibiotic administration within 1 week of study drug initiation or active severe infection within 4 weeks of study screening
• Active guttate, erythrodermic or pustular psoriasis
• Systemic psoriasis therapy or psoralen plus ultraviolet (UV) A phototherapy for 4 weeks before initiation of study