The role of hepatoprotection in the treatment of patients with severe psoriasis and concomitant pathology of the hepatobiliary system

Background. Psoriasis is one of the most common skin diseases with a wide range of comorbidities. Objective. To evaluate the efficacy of implementing a hepatoprotective drug into treatment regimens in patients with severe psoriasis and concomitant hepatobiliary pathology. Material and methods. A single-center, retrospective, comparative, open-label study based on the analysis of medical records of 100 patients with generalized psoriasis vulgaris was carried out. All participants showed abnormal liver function tests at the pre-hospital stage. Concomitant pathology of the hepatobiliary system was confirmed by anamnestic, clinical, laboratory and instrumental data. Patients were divided into two equal groups and received baseline therapy. Patients of the 1st group additionally received a hepatoprotective drug. The efficacy of treatment was assessed dynamically based on standard clinical and laboratory examination: PASI, transaminase levels (ALT, AST), alkaline phosphatase and gamma-glutamyl transferase. Results. Concomitant hepatobiliary system pathology in patients with psoriasis included non-alcoholic fatty liver disease (64%), cholelithiasis (28%), chronic viral hepatitis C (10%), biliary dyskinesia (8%), chronic calculous cholecystitis (7%), and unspecified hyperbilirubinemia (13%). An analysis of the dynamics of liver function tests depending on the treatment regimen showed a significantly greater efficacy of the treatment regimen in the group of patients who received a hepatoprotective drug in addition to the baseline therapy. This was evidenced by the positive dynamics of liver function tests, confirming the cytoprotective effect of the drug, and a higher clinical efficacy of the skin process resolution according to PASI. Conclusion. The inclusion of a hepatoprotective drug in the comprehensive therapy of psoriasis in patients with hepatobiliary comorbidity demonstrated an advantage over standard treatment protocols, as confirmed by the dynamics of PASI (p<0.05) and biochemical markers of cytolysis syndrome (p<0.05). The obtained data indicate the hepatoprotective and detoxifying effects of the drug, which contribute to increasing the efficacy of therapy for generalized psoriasis vulgaris.