Liver Disease Risk Higher With Psoriasis Than RA

Patients with psoriasis and psoriatic arthritis (PsA) had higher risk of liver disease, including nonalcoholic fatty liver disease (NAFLD), than patients with rheumatoid arthritis (RA), according to the findings of a recent study, regardless of systemic therapy use (ST).

Using the Health Improvement Network from 1994 to 2014, researchers examined incidence of liver disease, NAFLD, and cirrhosis among 197,130 patients with psoriasis, 12,308 patients with PsA, 54,251 patients with rheumatoid arthritis (RA), and 1,279,754 matched controls.
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The researchers found that patients with psoriasis, PsA, and RA without ST had elevated risks for any liver disease. Among patients with psoriasis, the HR was 1.97 for those receiving ST and was 1.37 for those without. The adjusted HR for those with PsA receiving ST and not receiving ST were 1.67 and 1.38, respectively. While the risk for liver disease was elevated for patients with RA not receiving ST, those receiving ST did not have an elevated risk (HR 1.49 vs 0.96, respectively).

In addition, NAFLD was highest among patients with psoriasis and PsA prescribed ST (HR 2.23 and 2.11, respectively). Likewise, the risk of cirrhosis was highest among patients with psoriasis with ST and PsA without ST (HR 2.62 and 3.15, respectively). The researchers found that the prevalence of liver disease and cirrhosis increased in a stepwise fashion with increasing body surface areas affected by psoriasis.

“More so than RA, psoriasis and PsA are associated with liver disease, particularly NAFLD and cirrhosis, and this was true even among patients without systemic therapy exposure,” the researchers concluded.

—Melissa Weiss

Reference:

Ogdie A, Grewal SK, Noe MH, et al. Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: a population-based study [published online November 2, 2017]. J Invest Dermatol. http://dx.doi.org/10.1016/j.jid.2017.10.024.