COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

Lodde, Georg; Krefting, Frederik; Placke, Jan‐Malte; Schneider, Lea; Fiedler, Melanie; Dittmer, Ulf; Becker, Jürgen C.; Hölsken, Stefanie; Schadendorf, Dirk; Ugurel, Selma; Sondermann, Wiebke

doi:10.3389/fimmu.2023.1107438

Cited by 4 publications

(4 citation statements)

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“…found that, in their cohort, 97.0% of patients seroconverted. Two patients did not seroconvert; both patients were on infliximab, one on monotherapy and the other in conjunction with methotrexate ( 28 ).…”

Section: Resultsmentioning

confidence: 99%

Psoriasis and biological drugs at the time of SARS-CoV-2 infection: a mini review outlining risk of infection, seroprevalence, and safety and efficacy of the BNT162b2 vaccine

Railton,

Volonté,

Isoletta

et al. 2024

Front. Immunol.

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ObjectiveThe aim of this study is to review the life of patients with psoriasis on biologic therapy during the SARS-CoV-2 pandemic and the relevance of frailty within this context, reviewing studies that describe the course and severity of infection in patients with psoriasis on biologics, the seroprevalence of SARS-CoV-2, and the safety and efficacy of the BNT162b2 vaccine in these patients.Materials and methodsThe keywords “Psoriasis,” “Biologics,” “SARS-CoV-2,” “COVID-19,” and “BNT162b2 Vaccine” were used in various combinations on database engines to find relevant articles on this topic.ResultsA total of 36 articles were found, with 20 concerning the course, severity, and seroprevalence of SARS-CoV-2 in patients with psoriasis on biologic therapy and 16 concerning safety and efficacy of BNT162b2 in these patients.DiscussionPatients with psoriasis on biologic therapy did not have increased seroprevalence compared with the general population, indicating that they were not at an increased risk of SARS-CoV-2 infection compared with the general population. Furthermore, the immunosuppressive action of biologics may be protective, as patients on biologic therapy had better outcomes and less risk of severe infection. The seroconversion rate against SARS-CoV-2 from the BNT162b2 vaccine was similar in both patients with psoriasis on biologics and the general population, indicating that efficacy is not hindered by the biologic therapy. However, the cellular response in population with psoriasis was significantly less intense, and the humoral immune response was weaker than that in the general population, demonstrating that the possibility of tighter vaccination schedules and additional doses may be advantageous in these patients.

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Section: Resultsmentioning

confidence: 99%

Psoriasis and biological drugs at the time of SARS-CoV-2 infection: a mini review outlining risk of infection, seroprevalence, and safety and efficacy of the BNT162b2 vaccine

Railton,

Volonté,

Isoletta

et al. 2024

Front. Immunol.

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“…Serum testing revealed that their anti-SARS-CoV-2-S IgG seroconversion rates were high, and none of the patients had developed symptomatic COVID-19 or died from COVID-19. 22 Another study demonstrated that all patients with the heterologous versus homologous COVID-19 vaccination produced anti-SARS-CoV-2 antibodies after vaccination. 23 In conclusion, the benefits of COVID vaccinations outweigh the risks to patients with psoriasis and patients with psoriasis should receive a COVID vaccine as soon as one is available.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on medical care conduct and psychological burden among patients with psoriasis: real-world data from a tertiary hospital in China

Zhang

Guo

Zhang

2023

International Journal of Dermatology and Venereology

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Objective: The ongoing coronavirus disease 2019 (COVID-19) epidemic has caused extensive damage worldwide. We explored whether the medical care conduct of patients with psoriasis has changed and whether the COVID-19 epidemic has placed more psychological pressure on these patients. Methods: A questionnaire survey was administered to patients with psoriasis in the Dermatology Department of Peking University Third Hospital in July 2022. Information about the patients’ general demographics, psoriasis condition, mental state of anxiety (Generalized Anxiety Disorder-7 [GAD-7] score), changes in medical care conduct, and Concerns about COVID-19-Related Risk Score for Psoriasis (CCRSP, a self-designed questionnaire) was collected. Univariate analysis with the Mann–Whitney U test for continuous variables was used in the estimation of statistical differences. Results: A total of 112 patients with psoriasis completed the survey. Purchasing medicine was the factor that added difficulty for most participants (32.1%). Fewer participants (26.8%) encountered medical registration difficulties than economic and transportation difficulties. Nearly three-quarters of participants (73.2%) reported at least one medical care conduct change resulting from the COVID-19 epidemic. A small proportion of participants (12.5%) thought that COVID-19 prevented them from seeking medical services for psoriasis. The top three items that caused the most concern were psoriasis aggravation resulting from drug reduction and withdrawal because of COVID-19 (44.7%), psoriasis aggravation after infection with COVID-19 (38.4%), and psoriasis-related side effects of the COVID-19 vaccine (35.7%). The GAD-7 score of patients with a high CCRSP (score of >10) was significantly higher than that of patients with a low CCRSP (score of ≤10) (nonparametric test, P = 0.047). Conclusion: COVID-19 poses challenges and places a mental burden on patients with psoriasis. Doctors should regulate the medical behavior of patients with psoriasis according to their specific COVID-19 situation and help patients ease their anxiety to maintain the stability of their psoriasis condition.

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“…Usually, biologicals are used as second-line treatment and, in special cases (e.g., PASI > 20, significant impairment of quality of life, or rapid disease progression), also as first-line therapy ( 32 ). In previous vaccination trials, MTX was shown to have a significant impact on vaccine responses in patients with plaque psoriasis ( 6 , 33 , 34 ). Due to the high incidence of side effects associated with MTX treatment, immunosuppressive therapy regimens are increasingly shifting from MTX to targeted interleukin inhibitor therapies ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with psoriasis under immunosuppressive therapy are at an increased risk of infectious complications, including lower respiratory tract infections or pneumonia due to the impairment of the immune system caused by the therapy. This applies in particular to treatment regimens with MTX and TNF-α blockers ( 6 ). Pneumonia is the most common fatal infectious disease in industrialized countries.…”

Section: Introductionmentioning

confidence: 99%

Antibody responses after sequential vaccination with PCV13 and PPSV23 in patients with moderate to severe plaque psoriasis under immunosuppressive therapy

Helmer,

van de Sand,

Wojtakowski

et al. 2024

mBio

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A crucial step in lowering the risk of invasive pneumococcal illness in high-risk populations, such as individuals with plaque psoriasis, is pneumococcal vaccination. The serologic response to the sequential vaccination with Prevenar 13 (PCV13) and Pneumovax 23 (PPSV23) in psoriasis patients under immunosuppressive therapy is still poorly characterized despite national recommendations suggesting vaccination for immunocompromised patients. In this prospective study, we investigated the serological response in 57 patients under active systemic treatment for moderate to severe plaque psoriasis who underwent sequential vaccination with PCV13 followed by PPSV23. Our analysis focused on global and serotype-specific anti-pneumococcal antibody responses over a 7-month period post-vaccination. Our findings reveal a robust serological response in patients with plaque psoriasis under systemic therapy. When comparing our results with a cohort of kidney transplant recipients who completed a similar sequential vaccination protocol, psoriasis patients showed higher antibody concentrations. In psoriasis patients, the mean levels of all global antibody classes tested (IgG, IgG2, IgA, IgM) increased more than 4-fold ( P < 0.0001) and serotype-specific antibodies more than 1.9-fold ( P < 0.01). In addition to providing strong evidence of the safety and effectiveness of sequential pneumococcal vaccination in individuals with plaque psoriasis, our work sheds light on the complex interactions that exist between immunosuppressive treatment, vaccination schedule, and antibody responses in various risk groups. IMPORTANCE To protect against severe courses of infection with Streptococcus pneumoniae , the national guidelines recommend sequential vaccination for these patients. However, there are only studies on the efficacy of a single administration of these vaccines in this particular risk group. The immunological responses to the vaccine were correlated with clinical patient data. In summary, our study shows for the first time that sequential vaccination is immunogenic in patients with moderate to severe plaque psoriasis.

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COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

Cited by 4 publications

References 80 publications

Psoriasis and biological drugs at the time of SARS-CoV-2 infection: a mini review outlining risk of infection, seroprevalence, and safety and efficacy of the BNT162b2 vaccine

Psoriasis and biological drugs at the time of SARS-CoV-2 infection: a mini review outlining risk of infection, seroprevalence, and safety and efficacy of the BNT162b2 vaccine

Impact of COVID-19 on medical care conduct and psychological burden among patients with psoriasis: real-world data from a tertiary hospital in China

Antibody responses after sequential vaccination with PCV13 and PPSV23 in patients with moderate to severe plaque psoriasis under immunosuppressive therapy

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