Prevalence of biological liver test abnormalities in psoriasis patients

[Fred]

This study looked at the prevalence of biological liver test abnormalities in psoriasis patients during psoriasis flares.

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Background:
Few epidemiologic data are available regarding biologic liver abnormalities during psoriasis flares.

Objectives:
The aim of this study was to assess the prevalence of biological liver test abnormalities (LTA) in a psoriasis population and the risk factors associated with LTA.

Methods:
A retrospective cross-sectional study in four hospital dermatology tertiary care centres included patients admitted for severe psoriasis flare between 1st January 2010 and 31st December 2011. During the same period, a control population was selected comprising patients admitted for contact and/or atopic eczema. Data were collected on hospital records and biology software. LTA was defined as serum AST and/or ALT and/or ALP concentration above the upper normal limit (UNL) and/or GGT concentration above 2 UNL. Prevalence of LTA with 95% confidence intervals (95% CI) was compared between the psoriatic and control populations. Factors associated with LTA at P < 0.05 were considered for the final multivariate logistic regression model.

Results:
Two hundred and forty psoriasis patients and 96 eczema control patients were included. One hundred and fifty-five(64.6%) of the psoriasis patients were male, aged 55 years on average (±17.6); 192 (80.0%) had plaque-type psoriasis (PV) and 52 (21.6%) had localized (n = 32) or generalized (n = 20) pustular psoriasis (PP). Prevalence of LTA was 36% (95% CI, 30–42) in the psoriatic population, significantly higher than in controls (17%, 95% CI 9.5–25). Risk factors independently associated with LTA comprised PV (OR 3.79; 95% CI 1.48–9.65), PP (OR 3.80; 95% CI 1.40–10.25) and previously diagnosed liver disease (underlying hepatic steatosis, viral hepatitis or excessive alcohol consumption) (OR 3.88; 95% CI 2.02–7.45). No association was found with systemic antipsoriatic drug therapies.

Conclusion:
In severe psoriasis, liver impacting comorbidities and/or specific psoriatic inflammation, the latter mostly in PP cases, more than drug-related liver toxicity, appears to predominantly account for LTA. Clinicians should be aware of this, to avoid unjustified withdrawal of useful systemic drugs.

Source: onlinelibrary.wiley.com

*Early view funding unknown.

[Caroline]

Seems to me a quite important conclusion. All to often dermatologists have the tendency to stop treatments with minor reasons. This shows that you should not do this too easy.