Risk of incident liver disease in patients with psoriasis psoriatic arthritis and rheumatoid arthritis: a population-based study.

摘要

Relatively little is known about the risk for incident liver disease in psoriasis (PsO), psoriatic arthritis (PsA), and rheumatoid arthritis (RA). We performed a cohort study among patients with PsO, PsA, or RA and matched controls in The Health Improvement Network from 1994-2014. Outcomes of interest were any liver disease, non-alcoholic fatty liver disease (NAFLD), and cirrhosis (any etiology). Among patients with psoriasis (N=197,130), PsA (N=12,308), RA (N=54,251), and matched controls (N=1,279,754), the adjusted hazard ratios for any liver disease were elevated among patients with PsO (without systemic therapy HR 1.37; with systemic therapy/ST 1.97), PsA (without ST 1.38; with ST 1.67) and RA without a ST (1.49) but not elevated in RA patients prescribed a ST (0.96). Incident NAFLD was highest in patients with PsO prescribed a ST (2.23) and PsA with a ST (2.11). Risk of cirrhosis was highest among patients with PsO with an ST (2.62) and PsA without a ST (3.15). Additionally, the prevalence of liver disease and cirrhosis increased in a stepwise fashion with increasing body surface area affected by PsO (p for trend <0.001). More so than RA, PsO and PsA are associated with liver disease, particularly NAFLD and cirrhosis, and this was true even among patients without systemic therapy exposure.