10/08/2026
Coexisting liver disease complicates the treatment of psoriatic disease. The BALANCE study has been designed to examine this problem, and the first UK patient has now been recruited.
People with psoriasis and psoriatic arthritis are at increased risk of liver disease, in part because of the medicines used to manage their condition. When there is concurrent liver disease, treatment options narrow, and conventional assessment provides limited scope for monitoring change over time.
BALANCE is led by the Oxford Clinical Trials Research Unit's Experimental Medicine and Rheumatology group. The study will use CoverScan, our multi-organ MRI analysis solution, to quantify liver disease activity (with imaging biomarker cT1) after treatment with Bimekizumab, a drug that blocks inflammatory proteins used in routine care for psoriatic disease. CoverScan will also quantify the fat, structure and function in other organs (fat for the heart, pancreas, and across the body; inflammation and fibrosis in the heart, pancreas and kidneys; and other measures of volume and function in the heart and skeletal muscle).
BALANCE aims to recruit 30 participants with psoriasis or psoriatic arthritis across four NHS sites in England, each scanned at baseline and again at six months, producing paired organ-level measurements before and during treatment.
The study is significant for three reasons. It applies multi-organ imaging in rheumatology, extending our evidence base beyond hepatology into immune-mediated disease. It positions quantitative imaging endpoints within an interventional trial, where organ-level change must be measured repeatedly and reproducibly. It is conducted within routine NHS care, the setting in which such measurements must ultimately perform.
Where concurrent disease is present, single-organ assessment leaves clinically relevant questions unanswered. Studies of this kind are how the evidence for whole-body assessment is established.
Read more from OUH: https://www.ouh.nhs.uk/news/articles/2452/