Usefulness of fibro scan in assessing liver fibrosis in adult patients with psoriasis

Abstract

Background: Patients with psoriasis are at higher risk of developing “systemic” co-morbidities. Non alcoholic fatty liver disease (NAFLD) is found to be more prevalent among psoriasis patients, where it is closely associated with obesity, metabolic syndrome, and psoriatic arthropathy. Elderly participants with psoriasis are 70% more likely to have NAFLD than those without psoriasis independent of common NAFLD risk factors.Methotrexate is a commonly used drug in the management of psoriasis owing to its cost effectiveness and easy administration. In the presence of NAFLD the choice of potentially hepatotoxic drug therapy, such as methotrexate, should be considered with caution. By assessing the liver stiffness measurement (LSM), such drugs can be prescribed with caution in individual with significant liver fibrosis. We have conducted a study to assess the LSM in patients with psoriasis. Aim was to detect the proportion of liver fibrosis (LSM) in adult patients with psoriasis, which will help in choosing the correct treatment. Methods: Hospital based cross sectional study was conducted in 102 adults with psoriasis who were not treated with methotrexate. Transient elastography (TE) was performed in all and LSM was noted. Results: There was no statistically significant gender influence on LSM in patients with psoriasis. There was significant increase in liver fibrosis in psoriatic patients as age advances. Conclusions: Elderly patients with psoriasis are more likely to have liver fibrosis. Hepatotoxic drugs like methotrexate should be prescribed with caution in such patients, preferably after performing LSM.