TNF and psoriasis: With regards to CMVD, the treatment of psoriasis patients with etanercept for 4 months led to an 11% improvement in coronary flow reserve as reported in a randomized trial by Ikonomidis et al. [138], confirming the results of a previous prospective cohort study of 37 patients with psoriasis treated with TNF-α inhibitors by Piaserico et al. [139].