Combination of Antiplatelet Therapy in Psoriatic Diseases With Cardiovascular Comorbidities: A Thromboinflammatory Perspective in the Era of Biologic Therapies.

Cardiovascular disease (CVD) remains the leading cause of death worldwide and represents the most significant comorbidity associated with psoriatic disease. Despite significant advancements in biologic therapies for psoriasis skin lesions, the lack of specific recommendations in current clinical guidelines for managing psoriasis with cardiovascular comorbidities has left the burden of these comorbidities continuing to significantly impair patients' quality of life and impose a substantial economic strain on society. Platelets, as unique cells with dual roles in haemostasis and inflammation, are critically involved in both psoriatic disease and its cardiovascular comorbidities. Recent evidence suggests that combining antiplatelet agents with biologic therapy may be a promising strategy for treating psoriatic patients with coexisting cardiovascular diseases. This article covers the involvement of platelets in inflammatory responses, their role in linking cardiovascular comorbidities to psoriasis, the theoretical rationale for combining antiplatelet and biologic therapies, evaluates the current positioning of this therapeutic strategy and provides perspectives on future developments in this field. Current clinical guidelines and ongoing GCP trials lack relevant data on this approach; advancing this strategy could yield valuable evidence for future recommendations.