Effects of Guselkumab on the FIB-4 Index in Psoriasis Patients (EGIPT): A Three-Year Study

Psoriasis is associated with comorbidities like metabolic syndrome and nonalcoholic fatty liver disease, increasing the risk of liver fibrosis. This study evaluated the long-term effects of guselkumab on liver fibrosis in 154 psoriasis patients using the Fibrosis-4 (FIB-4) index, a noninvasive marker of fibrosis, over 3 years. Patients were stratified by baseline FIB-4 (>= 1.3 or < 1.3) and age (35-65 years). Mean FIB-4 values remained stable across all subgroups, with no significant changes observed. High-risk patients (FIB-4 >= 1.3) showed minor, nonsignificant fluctuations, while low-risk patients (FIB-4 < 1.3) exhibited a mild, age-related upward trend. Disease duration emerged as a key factor influencing FIB-4, highlighting the importance of early treatment. These findings suggest guselkumab does not contribute to liver fibrosis progression in psoriasis patients. Further research with advanced methods like imaging or biopsy is needed to confirm the long-term hepatic safety of IL-23 inhibitors like guselkumab.