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["project_title"]=>
string(103) "The Impact of IL-23 Blockade on the Progression of Metabolic-Associated Steatotic Liver Disease (MASLD)"
["project_narrative_summary"]=>
string(729) "This study explores whether IL-23 inhibitors, drugs used to treat psoriasis, can also help improve liver health in people with metabolic-associated steatotic liver disease (MASLD). Psoriasis is a chronic inflammatory skin condition linked to other health issues like obesity, diabetes, and MASLD. Both conditions share underlying inflammation, making IL-23 a potential treatment target.
The study will analyze data from psoriasis patients treated with IL-23 blockers over five years, monitoring liver function and metabolic health. If IL-23 blockade is shown to slow liver disease progression, it could lead to new uses for existing medications and improve outcomes for people living with both psoriasis and MASLD."
["project_learn_source"]=>
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["first_name"]=>
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["last_name"]=>
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["email"]=>
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["p_pers_degree"]=>
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["property_scientific_abstract"]=>
string(1365) "Background:
Metabolic-associated steatotic liver disease (MASLD) is a prevalent liver condition linked to obesity, diabetes, and metabolic syndrome. Psoriasis, a chronic inflammatory skin disorder, is strongly associated with MASLD through shared inflammatory and metabolic pathways. Interleukin-23 (IL-23) is a key cytokine in psoriasis pathogenesis and may contribute to MASLD progression. IL-23 inhibitors, already approved for psoriasis, could offer therapeutic benefits for MASLD.
Objective:
To evaluate the effects of IL-23 blockade on MASLD progression in patients with psoriasis.
Study Design:
Post-hoc, longitudinal observational study with baseline, annual, and 5-year follow-up assessments.
Participants:
Adults (≥18 years) with severe psoriasis and ongoing IL-23 inhibitor therapy.
Primary and Secondary Outcome Measures:
Primary: Change in liver fibrosis severity (FIB-4, Hepatic Steatosis Index, NAFLD fibrosis score, APRI).
Secondary: Changes in BMI, glucose, HbA1c, lipid profile, liver function, and renal markers.
Statistical Analysis:
Descriptive statistics, paired t-tests or Wilcoxon tests, linear mixed-effects models for repeated measures, and multivariate regression adjusting for confounders (p < 0.05).
"
["project_brief_bg"]=>
string(2651) "Metabolic-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is the most common chronic liver condition globally, affecting an estimated 25% of the population. It is strongly associated with obesity, type 2 diabetes mellitus, and metabolic syndrome, and can progress from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (Eslam et al., 2020). Psoriasis, a chronic immune-mediated inflammatory skin disease affecting 1–5% of the global population, is increasingly recognized as a systemic condition linked to comorbidities including MASLD, cardiovascular disease, and metabolic dysfunction (Bellinato et al., 2021).
The pathophysiological link between psoriasis and MASLD likely involves shared inflammatory pathways, insulin resistance, and cytokine-driven immune responses. Interleukin-23 (IL-23) is a key pro-inflammatory mediator in psoriasis pathogenesis and has been implicated in hepatic inflammation and metabolic dysregulation. Preclinical evidence suggests IL-23 blockade can improve glucose tolerance, insulin sensitivity, and hepatic steatosis (Galle-Treger et al., 2022).
Clinical evidence is now emerging for IL-23 inhibition in liver disease. A recent phase 1 trial demonstrated that the anti-IL-23 monoclonal antibody guselkumab was safe and well-tolerated in patients with alcohol-associated liver disease, supporting the feasibility of IL-23 blockade in chronic liver conditions (Diaz et al., 2025).
This project will evaluate the impact of IL-23 inhibitors, currently approved for psoriasis, on liver health in a real-world clinical population. By tracking liver fibrosis scores, metabolic markers, and long-term outcomes over five years, the study will determine whether IL-23 blockade has therapeutic or preventive effects on MASLD.
The significance of this work lies in its potential to repurpose existing, safe, and widely available therapies for a common and progressive liver disease with no currently approved pharmacologic treatment. Findings from this research could provide generalizable scientific and clinical insights into the role of inflammatory modulation in MASLD, directly informing future treatment guidelines and public health strategies.
References:
1. Bellinato, F., et al. (2021). Life, 11(4), 338.
2. Eslam, M., et al. (2020). The Lancet Gastroenterology & Hepatology, 5(5), 397–417.
3. Galle-Treger, L., et al. (2022). Nature Communications, 13, 1440.
4. Diaz, L. A., et al. (2025). Aliment Pharmacol Ther, 61(7), 1140–1151.
"
["project_specific_aims"]=>
string(391) "Evaluate the therapeutic effect of IL-23 blockade on MASLD progression.
We will assess whether guselkumab, a Il23 inhibitor, reduces liver fibrosis and steatosis severity over five years in psoriasis patients with MASLD. Liver fibrosis and steatosis will be evaluated using validated non-invasive scores, including FIB-4, Hepatic Steatosis Index (HSI), NAFLD fibrosis score, and APRI."
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["project_purposes"]=>
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["label"]=>
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["project_research_methods"]=>
string(21) "no exclusion criteria"
["project_main_outcome_measure"]=>
string(743) "Primary Outcome Measures
Change in liver fibrosis severity, as assessed by:
FIB-4 score
Hepatic Steatosis Index (HSI)
NAFLD fibrosis score
APRI index
Secondary Outcome Measures
Changes in metabolic parameters:
Body Mass Index (BMI)
Blood glucose, insulin, and glycated hemoglobin (HbA1c)
Lipid profile (total cholesterol, LDL, HDL, triglycerides)
Changes in liver function tests (AST, ALT, platelet count, albumin)
Renal function markers (urea, creatinine)
Incidence of cirrhosis or hepatocellular carcinoma (if applicable during follow-up)"
["project_main_predictor_indep"]=>
string(213) "The scores will be calculated at baseline, annually, and at the 5-year follow-up to assess both absolute changes and trends over time.
BMI and fasting glucose will be the main independent variables"
["project_other_variables_interest"]=>
string(1018) "In addition to the primary predictor (fibrosis/steatosis severity scores), the following variables will be included to characterize the study sample and for use as covariates in multivariable analyses. These variables are selected based on known associations with MASLD progression and potential confounding effects.
Demographics:
Age (continuous, years)
Sex (male/female)
Anthropometric Data:
Body weight (continuous, kg)
Height (continuous, cm)
BMI (continuous, kg/m²; categorized: underweight 20 g/day for women, >30 g/day for men])
Laboratory Data:
Lipid profile: total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides (continuous, mg/dL)
Glycemic control: fasting glucose, fasting insulin, HbA1c (continuous)
Liver function: AST, ALT, platelet count, albumin (continuous)
Renal function: urea, creatinine (continuous)"
["project_stat_analysis_plan"]=>
string(1265) "Statistical Analysis Plan
Overview:
The primary analysis will evaluate changes in fibrosis and steatosis scores over a 5-year period in participants from the VOYAGE 1 and VOYAGE 2 randomized controlled trials, comparing guselkumab and comparator groups.
Descriptive Analysis:
Baseline characteristics and fibrosis/steatosis scores (FIB-4, HSI, NAFLD Fibrosis Score, APRI) will be summarized using means ± SD or medians (IQR) for continuous variables and frequencies (%) for categorical variables.
Normality will be assessed using Shapiro–Wilk tests and graphical inspection.
Primary Analysis:
Linear mixed-effects models will evaluate changes in fibrosis/steatosis scores over time (baseline to year 5), with random intercepts for participants to account for repeated measures.
Each score will be modeled separately, adjusting for potential confounders: age, sex, BMI, diabetes status, alcohol consumption, baseline liver function, and comorbidities.
Statistical Significance:
Two-sided p-values < 0.05 will be considered statistically significant.
Analyses will be performed using R (version ≥ 4.2)."
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["project_timeline"]=>
string(410) "Key Milestone Dates
Anticipated Project Start Date: 1 October 2025
Data Preparation and Cleaning Completed: 14 October 2025
Primary and Secondary Analyses Completed: 14 November 2025
Manuscript Drafted: 1 March 2026
Manuscript First Submitted for Publication: 1 June 2025
Results Reported to the YODA Project: 1 May 2025"
["project_dissemination_plan"]=>
string(1053) "The primary product of this project will be a peer-reviewed manuscript reporting the association between IL-23 blockade (guselkumab) and changes in validated liver fibrosis and steatosis scores over 5 years in patients with psoriasis from the VOYAGE 1 and VOYAGE 2 randomized controlled trials. Secondary outputs may include conference abstracts and poster/oral presentations summarizing key findings for dermatology, hepatology, and metabolic disease audiences.
The target audience includes clinicians, researchers, and policymakers in dermatology, hepatology, endocrinology, and public health, as well as patient advocacy groups. The findings will be relevant for advancing understanding of shared inflammatory pathways between psoriasis and MASLD, and for evaluating the potential of IL-23 inhibitors as repurposed therapies for liver disease.
Potential journals for submission include Journal of Hepatology, Hepatology, The Lancet Gastroenterology & Hepatology, JAMA Dermatology, and British Journal of Dermatology."
["project_bibliography"]=>
string(2672) "References
-
Balak DMW, Piaserico S, Kasujee I. Non-Alcoholic Fatty Liver Disease (NAFLD) in patients with psoriasis: A review of the hepatic effects of systemic therapies. Psoriasis (Auckl). 2021;11:151-168. doi:10.2147/PTT.S342911. PMID: 34909410; PMCID: PMC8665778.
-
Bellinato F, et al. Psoriasis and non-alcoholic fatty liver disease: A systematic review. Life. 2021;11(4):338. doi:10.3390/life11040338.
-
Diaz LA, Morris S, Dave S, Kim SM, Sarik W, Richards L, Madamba E, Bettencourt R, Fulinara C, Pham T, Miller G, Carvalho-Gontijo Weber R, Momper JD, He F, Jain S, Jamieson C, Kisseleva T, Brenner D, Loomba R. Clinical trial to assess the safety and tolerability of anti-IL 23 monoclonal antibody guselkumab in patients with alcohol-associated liver disease. Aliment Pharmacol Ther. 2025;61(7):1140-1151. doi:10.1111/apt.70026. Epub 2025 Feb 14. PMID: 39949265; PMCID: PMC12087978.
-
Eslam M, et al. MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Lancet Gastroenterol Hepatol. 2020;5(5):397-417. doi:10.1016/S2468-1253(20)30038-3.
-
Galle-Treger L, Helou DG, Quach C, Howard E, Hurrell BP, Muench GRA, Shafiei-Jahani P, Painter JD, Iorga A, Dara L, Emamaullee J, Golden-Mason L, Rosen HR, Soroosh P, Akbari O. Autophagy impairment in liver CD11c+ cells promotes non-alcoholic fatty liver disease through production of IL-23. Nat Commun. 2022;13:1440. doi:10.1038/s41467-022-29174-y.
-
Ortolan A, Lorenzin M, Tadiotto G, Russo FP, Oliviero F, Felicetti M, D’Incà R, Favero M, Piaserico S, Doria A, Ramonda R. Metabolic syndrome, non-alcoholic fatty liver disease and liver stiffness in psoriatic arthritis and psoriasis patients. Clin Rheumatol. 2019;38(10):2843-2850. doi:10.1007/s10067-019-04646-7. Epub 2019 Jun 28. PMID: 31254236.
"
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Research Proposal
Project Title:
The Impact of IL-23 Blockade on the Progression of Metabolic-Associated Steatotic Liver Disease (MASLD)
Scientific Abstract:
Background:
Metabolic-associated steatotic liver disease (MASLD) is a prevalent liver condition linked to obesity, diabetes, and metabolic syndrome. Psoriasis, a chronic inflammatory skin disorder, is strongly associated with MASLD through shared inflammatory and metabolic pathways. Interleukin-23 (IL-23) is a key cytokine in psoriasis pathogenesis and may contribute to MASLD progression. IL-23 inhibitors, already approved for psoriasis, could offer therapeutic benefits for MASLD.
Objective:
To evaluate the effects of IL-23 blockade on MASLD progression in patients with psoriasis.
Study Design:
Post-hoc, longitudinal observational study with baseline, annual, and 5-year follow-up assessments.
Participants:
Adults (>=18 years) with severe psoriasis and ongoing IL-23 inhibitor therapy.
Primary and Secondary Outcome Measures:
Primary: Change in liver fibrosis severity (FIB-4, Hepatic Steatosis Index, NAFLD fibrosis score, APRI).
Secondary: Changes in BMI, glucose, HbA1c, lipid profile, liver function, and renal markers.
Statistical Analysis:
Descriptive statistics, paired t-tests or Wilcoxon tests, linear mixed-effects models for repeated measures, and multivariate regression adjusting for confounders (p < 0.05).
Brief Project Background and Statement of Project Significance:
Metabolic-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is the most common chronic liver condition globally, affecting an estimated 25% of the population. It is strongly associated with obesity, type 2 diabetes mellitus, and metabolic syndrome, and can progress from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (Eslam et al., 2020). Psoriasis, a chronic immune-mediated inflammatory skin disease affecting 1--5% of the global population, is increasingly recognized as a systemic condition linked to comorbidities including MASLD, cardiovascular disease, and metabolic dysfunction (Bellinato et al., 2021).
The pathophysiological link between psoriasis and MASLD likely involves shared inflammatory pathways, insulin resistance, and cytokine-driven immune responses. Interleukin-23 (IL-23) is a key pro-inflammatory mediator in psoriasis pathogenesis and has been implicated in hepatic inflammation and metabolic dysregulation. Preclinical evidence suggests IL-23 blockade can improve glucose tolerance, insulin sensitivity, and hepatic steatosis (Galle-Treger et al., 2022).
Clinical evidence is now emerging for IL-23 inhibition in liver disease. A recent phase 1 trial demonstrated that the anti-IL-23 monoclonal antibody guselkumab was safe and well-tolerated in patients with alcohol-associated liver disease, supporting the feasibility of IL-23 blockade in chronic liver conditions (Diaz et al., 2025).
This project will evaluate the impact of IL-23 inhibitors, currently approved for psoriasis, on liver health in a real-world clinical population. By tracking liver fibrosis scores, metabolic markers, and long-term outcomes over five years, the study will determine whether IL-23 blockade has therapeutic or preventive effects on MASLD.
The significance of this work lies in its potential to repurpose existing, safe, and widely available therapies for a common and progressive liver disease with no currently approved pharmacologic treatment. Findings from this research could provide generalizable scientific and clinical insights into the role of inflammatory modulation in MASLD, directly informing future treatment guidelines and public health strategies.
References:
1. Bellinato, F., et al. (2021). Life, 11(4), 338.
2. Eslam, M., et al. (2020). The Lancet Gastroenterology & Hepatology, 5(5), 397--417.
3. Galle-Treger, L., et al. (2022). Nature Communications, 13, 1440.
4. Diaz, L. A., et al. (2025). Aliment Pharmacol Ther, 61(7), 1140--1151.
Specific Aims of the Project:
Evaluate the therapeutic effect of IL-23 blockade on MASLD progression.
We will assess whether guselkumab, a Il23 inhibitor, reduces liver fibrosis and steatosis severity over five years in psoriasis patients with MASLD. Liver fibrosis and steatosis will be evaluated using validated non-invasive scores, including FIB-4, Hepatic Steatosis Index (HSI), NAFLD fibrosis score, and APRI.
Study Design:
Individual trial analysis
What is the purpose of the analysis being proposed? Please select all that apply.:
New research question to examine treatment effectiveness on secondary endpoints and/or within subgroup populations
Software Used:
R
Data Source and Inclusion/Exclusion Criteria to be used to define the patient sample for your study:
no exclusion criteria
Primary and Secondary Outcome Measure(s) and how they will be categorized/defined for your study:
Primary Outcome Measures
Change in liver fibrosis severity, as assessed by:
FIB-4 score
Hepatic Steatosis Index (HSI)
NAFLD fibrosis score
APRI index
Secondary Outcome Measures
Changes in metabolic parameters:
Body Mass Index (BMI)
Blood glucose, insulin, and glycated hemoglobin (HbA1c)
Lipid profile (total cholesterol, LDL, HDL, triglycerides)
Changes in liver function tests (AST, ALT, platelet count, albumin)
Renal function markers (urea, creatinine)
Incidence of cirrhosis or hepatocellular carcinoma (if applicable during follow-up)
Main Predictor/Independent Variable and how it will be categorized/defined for your study:
The scores will be calculated at baseline, annually, and at the 5-year follow-up to assess both absolute changes and trends over time.
BMI and fasting glucose will be the main independent variables
Other Variables of Interest that will be used in your analysis and how they will be categorized/defined for your study:
In addition to the primary predictor (fibrosis/steatosis severity scores), the following variables will be included to characterize the study sample and for use as covariates in multivariable analyses. These variables are selected based on known associations with MASLD progression and potential confounding effects.
Demographics:
Age (continuous, years)
Sex (male/female)
Anthropometric Data:
Body weight (continuous, kg)
Height (continuous, cm)
BMI (continuous, kg/m^2; categorized: underweight 20 g/day for women, >30 g/day for men])
Laboratory Data:
Lipid profile: total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides (continuous, mg/dL)
Glycemic control: fasting glucose, fasting insulin, HbA1c (continuous)
Liver function: AST, ALT, platelet count, albumin (continuous)
Renal function: urea, creatinine (continuous)
Statistical Analysis Plan:
Statistical Analysis Plan
Overview:
The primary analysis will evaluate changes in fibrosis and steatosis scores over a 5-year period in participants from the VOYAGE 1 and VOYAGE 2 randomized controlled trials, comparing guselkumab and comparator groups.
Descriptive Analysis:
Baseline characteristics and fibrosis/steatosis scores (FIB-4, HSI, NAFLD Fibrosis Score, APRI) will be summarized using means +/- SD or medians (IQR) for continuous variables and frequencies (%) for categorical variables.
Normality will be assessed using Shapiro--Wilk tests and graphical inspection.
Primary Analysis:
Linear mixed-effects models will evaluate changes in fibrosis/steatosis scores over time (baseline to year 5), with random intercepts for participants to account for repeated measures.
Each score will be modeled separately, adjusting for potential confounders: age, sex, BMI, diabetes status, alcohol consumption, baseline liver function, and comorbidities.
Statistical Significance:
Two-sided p-values < 0.05 will be considered statistically significant.
Analyses will be performed using R (version >= 4.2).
Narrative Summary:
This study explores whether IL-23 inhibitors, drugs used to treat psoriasis, can also help improve liver health in people with metabolic-associated steatotic liver disease (MASLD). Psoriasis is a chronic inflammatory skin condition linked to other health issues like obesity, diabetes, and MASLD. Both conditions share underlying inflammation, making IL-23 a potential treatment target.
The study will analyze data from psoriasis patients treated with IL-23 blockers over five years, monitoring liver function and metabolic health. If IL-23 blockade is shown to slow liver disease progression, it could lead to new uses for existing medications and improve outcomes for people living with both psoriasis and MASLD.
Project Timeline:
Key Milestone Dates
Anticipated Project Start Date: 1 October 2025
Data Preparation and Cleaning Completed: 14 October 2025
Primary and Secondary Analyses Completed: 14 November 2025
Manuscript Drafted: 1 March 2026
Manuscript First Submitted for Publication: 1 June 2025
Results Reported to the YODA Project: 1 May 2025
Dissemination Plan:
The primary product of this project will be a peer-reviewed manuscript reporting the association between IL-23 blockade (guselkumab) and changes in validated liver fibrosis and steatosis scores over 5 years in patients with psoriasis from the VOYAGE 1 and VOYAGE 2 randomized controlled trials. Secondary outputs may include conference abstracts and poster/oral presentations summarizing key findings for dermatology, hepatology, and metabolic disease audiences.
The target audience includes clinicians, researchers, and policymakers in dermatology, hepatology, endocrinology, and public health, as well as patient advocacy groups. The findings will be relevant for advancing understanding of shared inflammatory pathways between psoriasis and MASLD, and for evaluating the potential of IL-23 inhibitors as repurposed therapies for liver disease.
Potential journals for submission include Journal of Hepatology, Hepatology, The Lancet Gastroenterology & Hepatology, JAMA Dermatology, and British Journal of Dermatology.
Bibliography:
References
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Balak DMW, Piaserico S, Kasujee I. Non-Alcoholic Fatty Liver Disease (NAFLD) in patients with psoriasis: A review of the hepatic effects of systemic therapies. Psoriasis (Auckl). 2021;11:151-168. doi:10.2147/PTT.S342911. PMID: 34909410; PMCID: PMC8665778.
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Bellinato F, et al. Psoriasis and non-alcoholic fatty liver disease: A systematic review. Life. 2021;11(4):338. doi:10.3390/life11040338.
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Diaz LA, Morris S, Dave S, Kim SM, Sarik W, Richards L, Madamba E, Bettencourt R, Fulinara C, Pham T, Miller G, Carvalho-Gontijo Weber R, Momper JD, He F, Jain S, Jamieson C, Kisseleva T, Brenner D, Loomba R. Clinical trial to assess the safety and tolerability of anti-IL 23 monoclonal antibody guselkumab in patients with alcohol-associated liver disease. Aliment Pharmacol Ther. 2025;61(7):1140-1151. doi:10.1111/apt.70026. Epub 2025 Feb 14. PMID: 39949265; PMCID: PMC12087978.
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Eslam M, et al. MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Lancet Gastroenterol Hepatol. 2020;5(5):397-417. doi:10.1016/S2468-1253(20)30038-3.
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Galle-Treger L, Helou DG, Quach C, Howard E, Hurrell BP, Muench GRA, Shafiei-Jahani P, Painter JD, Iorga A, Dara L, Emamaullee J, Golden-Mason L, Rosen HR, Soroosh P, Akbari O. Autophagy impairment in liver CD11c+ cells promotes non-alcoholic fatty liver disease through production of IL-23. Nat Commun. 2022;13:1440. doi:10.1038/s41467-022-29174-y.
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Ortolan A, Lorenzin M, Tadiotto G, Russo FP, Oliviero F, Felicetti M, D'Incà R, Favero M, Piaserico S, Doria A, Ramonda R. Metabolic syndrome, non-alcoholic fatty liver disease and liver stiffness in psoriatic arthritis and psoriasis patients. Clin Rheumatol. 2019;38(10):2843-2850. doi:10.1007/s10067-019-04646-7. Epub 2019 Jun 28. PMID: 31254236.