Although, to date, randomized placebo-controlled trials (RCT) evaluating the impact of biologics on CV risk in psoriasis are lacking, a systemic meta-analysis revealed that TNF-α inhibitors were related with fewer cardiovascular events compared to topical treatment/phototherapy (RR 0.58) or methotrexate (RR 0.67) (92). This evidence concerns the gene TNF and psoriasis.