Biologic therapy for psoriasis is associated with the development of metabolic dysfunction-associated steatotic liver disease (MASLD). A study on the association of cardiometabolic conditions with psoriasis treatment

Background
Psoriasis requires a comprehensive assessment of concomitant diseases to make better therapeutic decisions. This study examined the differences in the onset and progression of associated cardiometabolic comorbidities in psoriasis patients based on their treatments.

Methods
A retrospective longitudinal study was conducted on patients aged over 13 years with psoriasis seen at a Northern Mexican Hospital between 2012 and 2023. Patients were categorized into three groups according on the type of treatment received: topical, systemic, and biologic. A logistic regression analysis was performed to identify predictors of comorbidity development.

Results
197 patients were included; 52.8% were women, with a mean (SD) age of 54.45 (16.91) years, divided into topical [n = 90 (45.7%)], systemic [n = 57 (29.1%)], and biologic [n = 50 (25.5%)] groups, metabolic dysfunction-associated steatotic liver disease (MASLD) was significantly more prevalent in the biologic group [22 (44%)], p < 0.001. The logistic regression showed that type 2 diabetes mellitus, biological treatments (OR = 5.798, p = 0.001), and body mass index (OR = 1.144, p = 0.002), predicted the development of MASLD with a Nagelkerke’s R2 of 0.400.

Conclusions
Psoriasis patients using biological therapies have a greater predisposition to MASLD. These patients should receive a comprehensive approach to identify metabolic conditions, and screening tests for MASLD are recommended.