{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:09:10Z","timestamp":1790726950341,"version":"4.1.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,30]]},"abstract":"<jats:p>Whilst procollagen type III N-terminal peptide (PIIINP) is recommended as a marker of liver fibrosis in patients with psoriasis on methotrexate, its efficacy is increasingly questioned. PIIINP is not specific as a marker of liver fibrosis, is expensive and has a lengthy turnaround time. There is growing evidence that methotrexate is not a direct cause of liver disease. Fibrosis-4 (FIB-4) is a validated screening score of liver fibrosis that has a substantial weight of evidence. FIB-4 scores are quick to calculate, minimally invasive and cost-effective. Our study reviews PIIINP use versus FIB-4 use in patients with psoriasis about to start or taking methotrexate therapy. This service evaluation demonstrates poor real-world adherence to PIIINP monitoring guidance and a lack of correlation between PIIINP and FIB-4 referral thresholds.<\/jats:p>","DOI":"10.1093\/skinhd\/vzag116","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:20:33Z","timestamp":1782922833000},"page":"835-837","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating serum procollagen type III N-terminal peptide use as a liver fibrosis screening test in patients with psoriasis receiving methotrexate: a retrospective service evaluation in comparison with the Fibrosis-4 (FIB-4) index"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9163-8964","authenticated-orcid":false,"given":"Gary","family":"Roulston","sequence":"first","affiliation":[{"name":"Department of Clinical Biochemistry, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conall","family":"McKinney","sequence":"additional","affiliation":[{"name":"Department of Dermatology, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Monaghan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"McMullan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"McKillop","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Alderdice","sequence":"additional","affiliation":[{"name":"Department of Dermatology, South Eastern Health and Social Care Trust, Ulster Hospital , Belfast ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"2026092919521952100_vzag116-B1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/bjd.14816","article-title":"British Association of Dermatologists\u2019 guidelines for the safe and effective prescribing of methotrexate for skin disease 2016","volume":"175","author":"Warren","year":"2016","journal-title":"Br J Dermatol"},{"key":"2026092919521952100_vzag116-B2","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/j.1365-2036.2006.03047.x","article-title":"Liver injury in long-term methotrexate treatment in psoriasis is relatively infrequent","volume":"24","author":"Berends","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"key":"2026092919521952100_vzag116-B3","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1093\/bjd\/ljae069","article-title":"Cumulative methotrexate dose is not associated with liver fibrosis in patients with a history of moderate-to-severe psoriasis","volume":"191","author":"Babakinejad","year":"2024","journal-title":"Br J Dermatol"},{"key":"2026092919521952100_vzag116-B4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/gutjnl-2017-314924","article-title":"Guidelines on the management of abnormal liver blood tests","volume":"67","author":"Newsome","year":"2018","journal-title":"Gut"},{"key":"2026092919521952100_vzag116-B5","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.jhep.2024.04.031","article-title":"EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)","volume":"81","author":"European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO)","year":"2024","journal-title":"J Hepatol"},{"key":"2026092919521952100_vzag116-B6","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1016\/j.jaad.2020.02.044","article-title":"Joint American Academy of Dermatology\u2013National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies","volume":"82","author":"Menter","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2026092919521952100_vzag116-B7","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1111\/ced.15242","article-title":"Monitoring for methotrexate-induced liver fibrosis in many UK dermatology centres is out of date and needs reform","volume":"47","author":"Raahimi","year":"2022","journal-title":"Clin Exp Dermatol"},{"key":"2026092919521952100_vzag116-B8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/bjd.21091","article-title":"O05: \u2018A raised P3NP is a matter of time\u2019: replacing P3NP with FIB-4 for monitoring of methotrexate-related liver fibrosis","volume":"187","author":"Raahimi","year":"2022","journal-title":"Br J Dermatol"}],"container-title":["Skin Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/6\/5\/835\/70411715\/vzag116.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/6\/5\/835\/70411715\/vzag116.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:52:22Z","timestamp":1790725942000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/skinhd\/article\/6\/5\/835\/8748408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":8,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,7,31]]},"published-print":{"date-parts":[[2026,9,30]]}},"URL":"https:\/\/doi.org\/10.1093\/skinhd\/vzag116","relation":{},"ISSN":["2690-442X"],"issn-type":[{"value":"2690-442X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,7,31]]}}}