Biologic Therapies, Psoriasis, and COVID-19: Our Experience at the Psoriasis Unit of the University of Naples Federico II

Camela, Elisa; Fabbrocini, Gabriella; Cinelli, Eleonora; Lauro, Wanda; Megna, Matteo

doi:10.1159/000513575

Cited by 14 publications

(10 citation statements)

References 5 publications

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“…Similar observations are also shown in their other two papers (51,52). Another observational study from Italy also observed that the incidence of COVID-19 observed in the cohort of patients with psoriasis (0.2%) is similar to that seen in the general population (0.31%), and the course of the disease was mild in most patients (53) and similar observational conclusions have been confirmed in other studies (54)(55)(56)(57).…”

Section: The Relationship Between Psoriasis and Covid-19supporting

confidence: 85%

Biologics for Psoriasis During the COVID-19 Pandemic

et al. 2021

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Coronavirus disease 2019 (COVID-19), a new form of acute infectious respiratory syndrome first reported in 2019, has rapidly spread worldwide and has been recognized as a pandemic by the WHO. It raised widespread concern about the treatment of psoriasis in this COVID-19 pandemic era, especially on the biologics use for patients with psoriasis. This review will summarize key information that is currently known about the relationship between psoriasis, biological treatments, and COVID-19, and vaccination-related issues. We also provide references for dermatologists and patients when they need to make clinical decisions. Currently, there is no consensus on whether biological agents increase the risk of coronavirus infection; however, current research shows that biological agents have no adverse effects on the prognosis of patients with COVID-19 with psoriasis. In short, it is not recommended to stop biological treatment in patients with psoriasis to prevent the infection risk, and for those patients who tested positive for SARS-CoV-2, the decision to pause biologic therapy should be considered on a case-by-case basis, and individual risk and benefit should be taken into account. Vaccine immunization against SARS-CoV-2 is strictly recommendable in patients with psoriasis without discontinuation of their biologics but evaluating the risk-benefit ratio of maintaining biologics before vaccination is mandatory at the moment.

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Section: The Relationship Between Psoriasis and Covid-19supporting

confidence: 85%

Biologics for Psoriasis During the COVID-19 Pandemic

et al. 2021

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“…Unfortunately, for reasons that remain unclear, the secondary immune response (the so-called “cytokine storm”) may be excessive and may be a factor leading to tissue integrity disorders, respiratory failure, or exacerbation of skin lesions. We cannot exclude the notion that biologics may reduce the production of pro-inflammatory cytokines, thereby reducing the negative impact of COVID-19 on the symptoms of psoriasis [ 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Influence of SARS-CoV-2 Virus Infection on the Course of Psoriasis during Treatment with Biological Drugs

et al. 2021

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Background and objectives: Biological treatment is an important and effective therapy for psoriasis. During the COVID-19 pandemic, it remains unclear whether this type of therapy affects the course of SARS-CoV-2 infection. The aim of the study was to observe patients with psoriasis undergoing biological or other systemic treatment in relation to the impact of SARS-CoV-2 infection on the course of psoriasis and the COVID-19 disease itself. Materials and methods: A one-year observational study included 57 patients with diagnosed psoriasis who qualified for biological treatment and a group of 68 similar patients who were administered a different systemic treatment. Patients were analyzed monthly for psoriasis (including Psoriasis Area Severity Index (PASI) assessment) and constantly for SARS-CoV-2 infection (telephone contact). Cases of COVID-19 were confirmed by Polymerase Chain Reaction (PCR) at the study center. Results: SARS-CoV-2 infection was confirmed by a positive Real Time Polymerase Chain Reaction (RT-PCR) test in eight patients (14.0%) with psoriasis on biological therapy. None of the cases in this group required hospitalization for COVID-19. Similar data were obtained in the control group. Specifically, 11 (16%) patients were confirmed to be infected with SARS-CoV-2. These results were statistically comparable (p > 0.05). In the group of patients undergoing biological treatment, six (75%) of eight patients developed an exacerbation of psoriasis during SARS-CoV-2 infection, and similar results were noted in the control group, with eight (72%) patients experiencing an exacerbation of psoriasis. Conclusions: Patients with psoriasis who were administered biological treatment or other systemic therapy may experience a mild course of SARS-CoV-2 infection but might also experience a temporary exacerbation of skin lesions.

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“…Our systematic search of the literature allowed us to identify 37 case reports and case series 20‐56 and 11 studies that corresponded to our research question but their data were provided descriptively and an effect measure could not be calculated 21,57‐66 . These data are included in Table S1.…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: COVID‐19 outcomes in patients receiving anti‐TNF treatments

Kokkotis

Kitsou

Xynogalas

et al. 2021

Aliment Pharmacol Ther

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Summary Background Accumulating evidence suggests a beneficial effective of tumour necrosis factor‐alpha (TNF‐α) inhibitors on the outcomes of COVID‐19 disease, which, however is not validated by all studies. Aims To perform a systematic review and meta‐analysis of existing reports to investigate the impact of anti‐TNF treatments on the clinical outcomes of COVID‐19 patients. Methods A systematic search at PubMed and SCOPUS databases using specific keywords was performed. All reports of COVID‐19 outcomes for patients receiving anti‐TNF therapy by September 2021 were included. Pooled effect measures were calculated using a random‐effects model. The Newcastle Ottawa Scale for observational studies was used to assess bias. Studies that were not eligible for meta‐analysis were described qualitatively. Results In total, 84 studies were included in the systematic review, and 35 were included in the meta‐analysis. Patients receiving anti‐TNF treatment, compared to non‐anti‐TNF, among COVID‐19 cases had a lower probability of hospitalisation (eight studies, 2555 patients, pooled OR = 0.53, 95% CI: 0.42‐0.67, I2 = 0) and severe disease defined as intensive care unit admission or death (two studies, 1823 patients, pooled OR = 0.63, 95% CI: 0.41‐0.96, I2 = 0), after adjustment for validated predictors of adverse disease outcomes. No difference was found for the risk for hospitalisation due to COVID‐19 in populations without COVID‐19 for patients receiving anti‐TNF treatment compared to non‐anti‐TNF (three studies, 5 994 958 participants, pooled risk ratio = 0.97, 95% CI: 0.68‐1.39, I2 = 20) adjusted for age, sex and comorbidities. Conclusions TNF‐α inhibitors are associated with a lower probability of hospitalisation and severe COVID‐19 when compared to any other treatment for an underlying inflammatory disease.

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Biologic Therapies, Psoriasis, and COVID-19: Our Experience at the Psoriasis Unit of the University of Naples Federico II

Cited by 14 publications

References 5 publications

Biologics for Psoriasis During the COVID-19 Pandemic

Biologics for Psoriasis During the COVID-19 Pandemic

Influence of SARS-CoV-2 Virus Infection on the Course of Psoriasis during Treatment with Biological Drugs

Systematic review with meta‐analysis: COVID‐19 outcomes in patients receiving anti‐TNF treatments

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