Effects of interleukin-17 inhibitors on hepatic fibrosis index in patients with psoriasis and metabolic dysfunction-associated fatty liver disease: Directed acyclic graphs

Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed.1 The feature of MAFLD is the inclusion of metabolic dysfunctions and is independent of alcohol intake. 2 Psoriasis is a dermatosis associated with metabolic syndrome and alcoholic intake.3 However, no information is available on the impact of MAFLD on the severity of psoriasis.Hepatic fibrosis is a prognostic factor in patients with MAFLD 1,2 and interleukin-17 (IL-17) is involved in the pathogenesis of hepatic fibrosis.4 IL-17 causes neutrophil infiltration, insulin resistance, and subsequent steatohepatitis.5 IL-17 is also involved in the pathogenesis of psoriasis, and IL-17 inhibitor (IL-17i) is an approved agent for psoriasis with high efficacy.3 Herein, we investigated the impact of MAFLD in patients with psoriasis.We also investigated the effect of IL-17i on hepatic fibrosis and its contributing factors.We enrolled 65 consecutive patients with psoriasis treated with IL-17i in this retrospective study approved by the Institutional Review Board of Kurume University School of Medicine (ID 21236).Data were collected before and 6 months after IL-17i treatment (secukinumab or Ixekizumab).The severity of psoriasis was evaluated by psoriasis area and severity index (PASI).3 MAFLD was di- Effects of interleukin-17 inhibitors on hepatic fibrosis index in patients with psoriasis and metabolic dysfunction-associated fatty liver disease: Directed acyclic graphs