Psoriasis and liver problems

[Fred]

This study looked at liver enzyme abnormalities in psoriasis patients and suggests 57% of problems are associated with drugs.

Quote:

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Background/Objectives:
Psoriasis patients have a higher risk of liver abnormalities such as non-alcoholic fatty liver disease (NAFLD), drug-induced hepatitis, alcoholic hepatitis and neutrophilic cholangitis, than the general population. Associated liver disease limits therapeutic options and necessitates careful monitoring. The aim of the study was to identify liver problems in psoriasis patients and to investigate the underlying causes as well as their course.

Methods:
The files of 518 psoriasis patients were retrospectively reviewed. Among these, 393 patients with relevant laboratory data were analysed for liver enzymes and their relation to the known risk factors for liver disease (obesity, diabetes mellitus, alcohol consumption, hepatotoxic medications, dyslipidemia, psoriatic arthritis and infectious hepatitis).

Results:
Among 393 patients, 24% and 0.8% developed liver enzyme abnormalities and cirrhosis, respectively. The most common factors associated with pathological liver enzymes were drugs (57%) and NAFLD (22%). Other rare causes were alcoholic hepatitis, viral hepatitis, neutrophilic cholangitis, autoimmune hepatitis and toxic hepatitis due to herbal therapy. Drug-induced liver enzyme abnormalities were reversible whereas in patients with NAFLD transaminases tended to fluctuate. One patient with herbal medicine-related cirrhosis died of sepsis.

Conclusion:
Liver enzyme abnormalities are common in psoriasis patients and are mostly associated with drugs and NAFLD. Although most cases can be managed by avoiding hepatotoxic medications and close follow up, severe consequences like cirrhosis may develop.

Source: onlinelibrary.wiley.com

*Early view funding unknown

[jiml]

A very interesting study giving cause for some concern over the fact that some of the drugs used to control psoriasis, can cause liver problems
It is good to read that many of the disorders can be managed by avoiding certain drugs ...However a warning about the toxicity of some herbal treatments is a worry for those that choose the natural route

It's a shame it doesn't name the drugs more likely to cause problems  although most of the psoriasis drugs like methotrexate and NSAIDs are hepatotoxic

[Kat]

Thanks for the reminder to this post Fred. Psoriasis club is still helping me understand things I probably read this post before, but since it was prior to my fatty liver diagnosis, I didn't relate to it the same as I do now.

It is a bit concerning or at the very least a bit confusing when drugs that can help with psoriasis can harm the liver.

[Fred]

Thanks for the reminder to this post Fred.  Psoriasis club is still helping me understand things    I probably read this post before, but since it was prior to my fatty liver diagnosis, I didn't relate to it the same as I do now.

It is a bit concerning or at the very least a bit confusing when drugs that can help with psoriasis can harm the liver.

No problem Kat, as you know I live and breath this place and your comment got me thinking. I won't get on my soapbox about poison methotrexate being one of those treatments you mention, but yes it is concerning and confusing and at the end of the day we all have to decide what is best for us.

I love Bio's as they gave me my life back, some like Bill wouldn't touch them and prefers to self treat with (well some dodgy stuff in my opinion) but it's his choice. What I'm trying to say is there is a lot sometimes too much information, and what works for one may not work for another.

At the end of the day the patient has to make the choice.

[Caroline]

Your opinion concerning Bill, differs very much from my opinion, and I have the expertise….

[Fred]

Your opinion concerning Bill, differs very much from my opinion, and I have the expertise….   

I meant dodgy as in he imports it in it's raw form from China and eats it with his cornflakes, he even does his own blood tests. You are one of the DMF gang and I accept that it works, but I was trying to give a statement on how we all accept different ways of treating ourselves.

[Kat]

Yes it is a very diverse group of people here regarding treatments. It's what makes this so informative, having people with all different experiences.

I could not do what Bill does, I'd be so lost trying to figure it out but I admire his ability to treat himself.

When you're hearing the ads here you know the pharmaceuticals are trying to present it as the best thing ever (but have to mention the scary stuff) and then you have doctors who may have a strong opinion but probably have not used it themselves. It's good to come here and read real life experiences and then make the best decision one can.