Abstract Aim The aim of the study was to evaluate the changes in central vascular inflammation measured by FDG PET and myocardial blood flow reserve (MFR) determined by ⁸²Rb PET following therapy with biologic agents for 6 months in patients with psoriatic arthritis (PsA) and/or cutaneous psoriasis (PsO) (group 1) and compare with PsO subjects receiving non-biologic therapy (group 2) and controls (group 3). Methods and Results Target-to-background ratio (TBR) by FDG PET in the most diseased segment of the ascending aorta (TBR_max) was measured to assess vascular inflammation. ⁸²Rb PET studies were used to assess changes in left ventricular MFR. A total of 34 participants were enrolled in the study (11 in group 1, 13 in group 2, and 10 controls). A significant drop in the thoracic aorta uptake was observed in the biologic-treated group (ΔTBR_max: − .46 ± .55) compared to the PsO group treated with non-biologic therapy (ΔTBR_max: .23 ± .67). Those showing response to biologic agents maintained MFR compared to who showed no response. Conclusion In a cohort of psoriasis patients treated with biologics, FDG uptake in the thoracic aorta decreased over the study period. Patients who demonstrated a significant anti-inflammatory response on FDG PET imaging maintained their MFR compared to non-responders.