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

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.