José González Fernández, Lucía Prieto-Torres, Mariano Ara Martín, Samuel J Martínez-Domínguez
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引用次数: 0
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is more prevalent in patients with psoriasis compared to healthy individuals. Interleukin (IL)-17 and IL-23 inhibitors may have beneficial effects on MASLD by reducing systemic inflammation and improving metabolic parameters.
Objectives: To assess the effect of IL-17 and IL-23 inhibitors on MASLD and liver fibrosis in patients with psoriasis.
Design: We performed a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
Data sources and methods: A literature search was conducted across four databases: MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials, from database inception to September 27, 2024. Observational studies and clinical trials that reported the presence of MASLD and/or liver fibrosis in patients with psoriasis/psoriatic arthritis treated with IL-17 or IL-23 inhibitors were included. The Newcastle Ottawa Scale (NOS) was used for risk of bias assessment in cohort studies, the Revised Cochrane Risk of Bias Tool (RoB2.0) in randomized controlled trials, and the Risk of Bias in non-randomized studies-of Interventions (ROBINS-I v.2) tool in non-randomized trials.
Results: Fourteen studies were included: four clinical trials, five retrospective cohort studies, three prospective cohort studies, and two post hoc studies. Two cohort studies and one clinical trial showed a low risk of bias. Both post hoc studies had a high risk of bias. Eleven studies assessed the effect of IL-17 inhibitors on MASLD or liver fibrosis; six reported a neutral effect, while five demonstrated improvements in liver tests. Three studies evaluated IL-23 inhibitors; one showed neutral effects, another reported improvement in fibrosis-4 index (FIB-4) scores at 6 months, and the third was still in the recruitment phase.
Conclusion: IL-17 and IL-23 inhibitors may provide beneficial effects on MASLD and liver fibrosis in patients with psoriasis. Larger, well-designed studies are needed to confirm these findings.
背景：与健康人相比，代谢功能障碍相关的脂肪变性肝病（MASLD）在银屑病患者中更为普遍。白细胞介素(IL)-17和IL-23抑制剂可能通过减少全身炎症和改善代谢参数对MASLD有有益作用。目的：探讨IL-17和IL-23抑制剂对银屑病患者MASLD和肝纤维化的影响。设计：我们按照系统评价和荟萃分析指南的首选报告项目进行了系统评价。数据来源和方法：检索MEDLINE、Embase、Web of Science和Cochrane Central Register of Controlled Trials四个数据库，检索时间为数据库建立至2024年9月27日。观察性研究和临床试验报告了在接受IL-17或IL-23抑制剂治疗的银屑病/银屑病关节炎患者中存在MASLD和/或肝纤维化。在队列研究中使用纽卡斯尔渥太华量表（NOS）评估偏倚风险，在随机对照试验中使用修订Cochrane偏倚风险工具（RoB2.0）评估偏倚风险，在非随机试验中使用非随机干预研究（ROBINS-I v.2）工具评估偏倚风险。结果：纳入14项研究：4项临床试验、5项回顾性队列研究、3项前瞻性队列研究和2项事后研究。两项队列研究和一项临床试验显示偏倚风险较低。两项事后研究都有较高的偏倚风险。11项研究评估了IL-17抑制剂对MASLD或肝纤维化的影响；其中6人报告了中性效果，而5人在肝脏测试中表现出改善。三项研究评估了IL-23抑制剂；一个显示中性效果，另一个报告在6个月时纤维化-4指数（FIB-4）评分改善，第三个仍处于招募阶段。结论：IL-17和IL-23抑制剂可能对银屑病患者的MASLD和肝纤维化有有益作用。需要更大规模、设计良好的研究来证实这些发现。试验注册：PROSPERO CRD42024599350。
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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