Pfizer, which sells a version of methotrexate, has hired Gelfand and another study author as consultants and given them research grants, although the drugmaker wasn’t involved in the design or analysis of the current study. The authors have other financial ties to several other drug companies.
One limitation of the study is that researchers didn’t look at deaths from liver disease. Another drawback is that they lacked data on whether people at risk for liver disease might have been steered away from methotrexate to other therapies.
Even so, the findings add to evidence that patients need to consider the liver risks associated with these disorders, says Dr. Lawrence Eichenfield, a researcher at the University of California, San Diego, who wasn’t involved in the study.
“Patients should be aware that psoriasis has health [effects] beyond the skin alone, and its management should be considered as an important part of the health of an individual,” Eichenfield says by email. “Liver function tests should be tested in psoriasis patients and the results may influence choices for therapy.”
An alternative treatment for joint pain, non-steroidal anti-inflammatory drugs (NSAIDs), also carry a risk of liver disease, cautions Dr. Alexander Egeberg, a researcher at the University of Copenhagen who wasn’t involved in the study.
“Consequently, physicians should carefully weigh the risks and benefits of NSAIDs as well as methotrexate when treating patients with inflammatory diseases,” Egeberg says by email.
- Ogdie A, Grewal SK, Noe MH, et al. Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: a population-based study. J Invest Dermatol. 2017 Oct 27. pii: S0022-202X(17)33097-X. doi: 10.1016/j.jid.2017.10.024. [Epub ahead of print]