Changes in the FIB-4 index with IL-23 vs IL-17 inhibitors in psoriasis: a retrospective cohort study
Expert Opinion on Biological Therapy, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/14712598.2026.2746892
- Dergi Adı: Expert Opinion on Biological Therapy
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
- Anahtar Kelimeler: biomarkers, FIB-4 index, fibrosis, interleukin-17, interleukin-23, Psoriasis
- Kocaeli Üniversitesi Adresli: Evet
Özet
Background and objectives: Psoriasis is associated with risk of hepatic fibrosis, but the comparative hepatic profiles of interleukin (IL)-17 and IL-23 inhibitors remain uncertain. Methods: This two-center retrospective cohort included adults with psoriasis treated with IL-17 or IL-23 inhibitors. Six-month changes in the Fibrosis-4 index (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI), and 12-month ultrasonographic steatosis outcomes, were compared. Month-6 FIB-4 was analyzed using analysis of covariance adjusted for baseline FIB-4 and covariates. Results: Among 261 patients (IL-17, n = 129; IL-23, n = 132), 140 had both baseline and follow-up ultrasonography. Median ΔFIB-4 was −0.005 (interquartile range (IQR), −0.054 to 0.046) and −0.050 (−0.143 to −0.011), respectively. Adjusted ANCOVA showed lower month-6 FIB-4 with IL-23 treatment (β = −0.063, 95% confidence interval (CI) −0.091 to −0.034). FIB-4 improvement occurred in 12.4% and 32.6%, respectively. Among patients with baseline FIB-4 ≥1.30, median changes were −0.030 and −0.222 (adjusted β = −0.199, 95% CI − 0.265 to −0.133). Median ΔAPRI was −0.003 and −0.022. Platelet counts changed by −4.0 and +14.5 × 109/L, respectively (p = 0.031), while unadjusted transaminase changes did not differ. ΔPsoriasis Area and Severity Index (PASI) and ultrasonographic steatosis changes were comparable; no hepatic events occurred. Conclusions: IL-23 inhibition was associated with greater reductions in FIB-4 and APRI than IL-17 inhibition, particularly among patients with elevated baseline FIB-4. Prospective validation with elastographic confirmation is needed.