Psoriasis may be linked to advanced liver fibrosis

the Clinical Advisor take:

Older patients with psoriasis are at increased risk of advanced hepatic fibrosis even if the skin disease was mild enough to have never required systemic therapy, according to a study presented at the annual congress of the European Academy of Dermatology and Venereology.

“It could be suggested to screen for liver fibrosis ... before and during potentially hepatotoxic therapies in psoriasis patients, especially in those with metabolic syndrome,” said Ella van der Voort, MD, during the presentation.

To investigate the association between advanced hepatic fibrosis and psoriasis, van der Voort examined 1,535 patients enrolled in the Rotterdam Study, including 75 with psoriasis. The patients, aged a mean of 71 years, had mild skin disease, with a mean Psoriasis Area and Severity Index score of 2.0. Of the 75 patients with psoriasis, none received methotrexate or any other systemic therapy for their psoriasis.

The prevalence of advanced liver fibrosis was 8.1% in patients with psoriasis, compared with only 3.6% in the control group. In an multivariate analysis adjusted for alcohol consumption, alanine aminotransferase levels, steatosis, metabolic syndrome, age, and gender, psoriasis was independently associated with a 2.6% increased risk of advanced liver fibrosis.

In a subgroup of patients with nonalcoholic fatty liver disease (NAFLD), psoriasis was associated with a 15% increased risk of advanced hepatic fibrosis, compared with 4% of the 375 nonpsoratic controls with NAFLD, for an adjusted 4.1-fold increased risk among the group with psoriasis.