-Original-

Real-World Screening Data for Liver Fibrosis in Psoriasis Patients Treated with Biologics

Susumu Ichiyama¹, Michiko Ito¹, Saeko Ozaki¹, Taeang Arai², Masanori Atsukawa², Katsuhiko Iwakiri², Teppei Hagino³, Toshihiko Hoashi¹, Naoko Kanda³ and Hidehisa Saeki¹

¹Department of Dermatology, Nippon Medical School, Tokyo, Japan
²Department of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan
³Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is positively associated with the prevalence and severity of psoriasis. The fibrosis-4 (FIB-4) index was developed to predict significant liver fibrosis. Using the FIB-4 index, the present study evaluated screening data for liver fibrosis, including MASLD, in patients with refractory psoriasis treated with biologics.
Methods: All adult patients with psoriasis who were prescribed biologics at Nippon Medical School from August 2023 to May 2024 were included in this study. The FIB-4 index was classified as high (≥2.67), intermediate (1.30-2.66), and low (<1.30). Patients younger than 65 years were referred to a hepatologist if the FIB-4 index was high. If the score was intermediate, type IV collagen 7S (4COL7S) was checked, and they were referred to a hepatologist if it was ≥4.8 ng/mL. Patients aged ≥65 years were referred to a hepatologist if the FIB-4 index was high. If it was 2.00-2.66, they were referred to a hepatologist if the 4COL7S level was ≥4.8 ng/mL.
Results: Data from 96 patients were analyzed. The FIB-4 index was high in 10 patients, intermediate in 35 patients, and low in 51 patients. Eleven of 96 registered patients were newly referred to a hepatologist. Of these 11 patients, 5 received lifestyle guidance.
Conclusions: For patients with refractory psoriasis, close cooperation between dermatologists and hepatologists is essential to prevent progression of liver fibrosis.

J Nippon Med Sch 2024; 91: 534-540

Keywords
biologics, FIB-4 index, 4COL7S, liver fibrosis, psoriasis

Correspondence to
Hidehisa Saeki, MD, Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
h-saeki@nms.ac.jp

Received, August 8, 2024
Accepted, August 28, 2024