Patients with certain risk factors had increased rates of fibrosis.
AAD guidelines encourage periodic liver biopsy to monitor psoriasis patients undergoing methotrexate therapy. Psoriasis patients frequently have features of the metabolic syndrome, including insulin resistance, type 2 diabetes mellitus, and obesity; obesity itself has been linked to hepatosteatosis, which can lead to fibrosis and cirrhosis. In these patients, factors associated with the greatest risk for liver toxicity are obesity, having hepatitis or diabetes mellitus, and overconsumption of alcohol. Many experts, however, have questioned the value of liver biopsy.
These authors retrospectively analyzed 71 patients who had undergone a total of 169 liver biopsies during methotrexate therapy for psoriasis (generally, biopsies were performed a…