POS0022 NAFLD IN PSORIATIC DISEASE: IDENTIFYING PATIENTS AT HIGH RISK OF SERIOUS LIVER DISEASE

Background Patients with psoriatic disease(PsD) [psoriasis(PsO) and arthritis(PsA)] are at greater risk of non-alcoholic fatty liver disease(NAFLD) NAFLD-associated fibrosis/cirrhosis compared the general population other inflammatory arthritis(1) independent disease-modifying medications [biological(b)DMARDs or methotrexate(MTX)][2]. Conversely, using these in patients significant NAFLD might accelerate progression to fibrosis/cirrhosis[1]. The Leeds Teaching Hospitals NHS Trust(LTHT) screening pathway is not validated PsD may underestimate prevalence PsD[3]. Objectives: 1. To assess our 2. determine effectiveness LTHT for identifying Methods This audit included consecutive from Specialist Spondyloarthritis Dermatology departments who underwent pathway. Briefly, first screened ELF FIB4 scores. ELF>9.5 >1.45 triggers referral fibroscan hepatology opinion. A >10 was considered indicative clinically NAFLD. We baseline demographics (age, sex, BMI, diabetic status), biochemistry (ALT, AST, platelet count, albumin, hepatitis B C), tests (ELF, +/- ultrasound biopsy) final diagnosis (NAFLD/ fibrosis/ cirrhosis/ other). results arthritis (Other IA). Results Overall 110 were included; 86.4% (95/110) PsD, 14.6% (15/110) Other IA. Regarding demographic clinical variables, age, ALT, platelets albumin similar between all groups. IA more likely be male taking bDMARD monotherapy. No PsO bDMARDs over half on no DMARD(Table 1). scores higher group, possibly because P3NP peptide (part score) elevated active skin PsO. Contrastingly, FIB-4 PsA Higher scores, but associated a score (p=0.05 p=0.09 respectively). Conclusion had rates better than requiring exclude cirrhosis. Findings will now larger prospective cohort study. References [1]Prussick RB, et al. J Clin Aesthet Dermatol. 2015;8:43-45. [2]Prussick Br 2017;179:16-29. [3]LTHT Pathways – Suspected NAFLD/ ALD. http://lhp.leedsth.nhs.uk/leedspathways/DEtail.aspx?id=25 . Table Summary data PsA(n=59) PsO(n=36) IA(n=15) Age(years ) 52(±15) 48(±13) 49(±15) Sex(% 58(34/59) 47(17/36) 80(12/15) BMI(kg/m² 33(±5) 31(±7) 33(±7) Diabetes(% Yes 21(12/58) 11(4/36) 20(3/15) 67(39/58) 81(29/36) 73(11/15) Impaired Glucose Tolerance 13(7/58) 9(3/36) 7(1/15) DMARDs MTX 32(19/59) 39(14/36) 9(5/59) 0 67(10/15) + 36(21/59) 2(1/59) 3(1/36) None 22(13/59) 58(21/36) ALT 57(±32) 37(±26) 89(±45) AST 42(±22) 31(±16) 63(±41) Hepatitis C 1(1/59) >9.5(% 46(22/48) 70(23/33) 36(4/11) >1.3(% 38(19/50) 20(7/35) 27(3/11) Fibroscan median stiffness >10(% 31(15/48) 83(5/6) 25(3/12) Liver US Cirrhosis/fibrosis 10(4/41) 15(2/13) 8(1/13) 73(30/41) 77(10/13) 17(7/41) Normal Biopsy 46(5/11) 9(1/11) Diagnosis (% 12(7/59) 6(2/36) 66(39/59) 19(7/36) 80(11/15) 5(3/59) 75(27/36) 15(9/59) 13(2/15) Awaiting Acknowledgements: NIL. Disclosure Interests Declared.