The association between ACE inhibitors and psoriasis based on the drug-targeted Mendelian randomization and real-world pharmacovigilance analyses

Expert Rev Clin Pharmacol. 2024 Jan;17(1):93-100. doi: 10.1080/17512433.2023.2292605. Epub 2024 Jan 23.

Abstract

Background: Although a growing number of observational studies suggest that angiotensin-converting enzyme inhibitors (ACEIs) intake may be a risk factor for psoriasis, evidence is still insufficient to draw definitive conclusions.

Research design and methods: Drug-targeted Mendelian randomization (DTMR) was used to analyze the causality between genetic proxied ACEIs and psoriasis. Furthermore, we performed a disproportionality analysis based on the FDA adverse event reporting system (FAERS) database to identify more suspicious subclasses of ACEIs.

Results: Using two kinds of genetic proxy instruments, the present DTMR research identified genetic proxied ACEIs as risk factors for psoriasis. Furthermore, our disproportionality analysis revealed that ramipril, trandolapril, perindopril, lisinopril, and enalapril were associated with the risk of psoriasis, which validates and refines the findings of the DTMR.

Conclusions: Our integrative study verified that ACEIs, especially ramipril, trandolapril, perindopril, lisinopril, and enalapril, tended to increase the risk of psoriasis statistically.

Keywords: Psoriasis; angiotensin-converting enzyme inhibitor; drug safety; drug-target mendelian randomization; real-world pharmacovigilance analysis.

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors* / adverse effects
  • Enalapril / pharmacology
  • Humans
  • Lisinopril / pharmacology
  • Mendelian Randomization Analysis
  • Perindopril / adverse effects
  • Pharmacovigilance
  • Psoriasis* / drug therapy
  • Psoriasis* / genetics
  • Ramipril / adverse effects

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Ramipril
  • Lisinopril
  • Perindopril
  • Enalapril