P-88 EVALUATION OF STEATOSIS AND LIVER FIBROSIS IN PATIENTS WITH PSORIASIS: THE IMPACT OF METHOTREXATE AND METABOLIC FACTORS ON THE SEVERITY OF THE DISEASE

Introduction

Methotrexate (MTX) is a crucial treatment drug in Psoriasis. Its impact on the development of liver fibrosis has been questioned since a high prevalence of non-alcoholic fatty liver disease has been described in this disease.

Objective

To assess, in Psoriasis patients, the associated factors for liver steatosis and advanced fibrosis diagnosed by transient hepatic elastography (THE).

Methodology

This was a cross-sectional study in Psoriasis patients. Chronic liver diseases, use of steatogenic drugs (except MTX), and alcohol intake >20–30 g/day (women/men) were excluded. Demographic, anthropometric, clinical, and laboratory data were registered as well as time since psoriasis onset and cumulative MTX doses. THE cutoff points ≥7.9KPa (probe M) and ≥7.2KPa (probe XL) were considered for the diagnosis of advanced liver fibrosis and CAP values ≥248 dB/m for the diagnosis of steatosis. Logistic regression analysis was performed, and the significance level was 0.05.

Results

141 patients were included (42.6% male, 53.7±12.4 years old, body mass index [BMI] 29.3±5.9 kg/m2). The prevalence of Diabetes Mellitus (DM), Metabolic Syndrome, Systemic Arterial Hypertension (SAH), and dyslipidemia was 28.4%, 55.3%, 57.4% and 73.7%, respectively. Overall, 67.4% had steatosis by CAP and 16.3% had advanced fibrosis by THE. Median time since psoriasis onset was 121.1 months (69.5-234.1). MTX cumulative dose ≥1000mg was found in 47.8% (median 2212.5mg [1360-3213.70]). In the regression analysis, BMI (OR 1.25 95% CI 1.12-1.38; p<0.001) and triglyceride levels (OR 1.01 95% CI 1.01-1.02; p=0.002) were the only variables independently associated with steatosis. DM (OR 4.8 95% CI 1.6-14.3; p=0.005) and SAH (OR 11.6 95% CI 2.2-61.1; p=0.004) were associated with advanced fibrosis.

Conclusion

On a cohort of patients with Psoriasis, metabolic variables were the main factors related to liver steatosis and fibrosis. There was no association between cumulative MTX dose or disease duration and liver steatosis or fibrosis in this population.