New-onset and flares of psoriasis after COVID-19 infection or vaccination successfully treated with biologics: a case series

Gargiulo, Luigi; Ibba, Luciano; Vignoli, Carlo Alberto; Piscazzi, Francesco; Cortese, Andrea; Fiorillo, Giovanni; Toso, Francesco; Pavia, Giulia; Valenti, Mario; Avagliano, Jessica; Narcisi, Alessandra; Costanzo, Antonio

doi:10.1080/09546634.2023.2198050

Cited by 12 publications

(15 citation statements)

References 14 publications

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“…Furthermore, the research findings unveiled substantially higher rates of clinical improvement at the 16‐week milestone when compared to the outcomes reported in both clinical trials and real‐world studies. These findings serve as compelling evidence supporting the therapeutic effectiveness of biologics in patients with relatively short disease durations and underscore the safety of these treatment approaches in the context of the ongoing COVID‐19 pandemic 17,22,26,27,51 …”

Section: Discussionmentioning

confidence: 74%

“…These findings serve as compelling evidence supporting the therapeutic effectiveness of biologics in patients with relatively short disease durations and underscore the safety of these treatment approaches in the context of the ongoing COVID-19 pandemic. 17,22,26,27,51 Our analysis of ICU admission rate and the OR of COVID-19 infection in psoriasis patients compared to the general population revealed significant heterogeneity between studies. Due to the limited number of studies available, further exploration of the sources of heterogeneity was challenging.…”

Section: Discussionmentioning

confidence: 90%

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A systematic review and meta‐analysis of investigating the mutual impact of COVID‐19 and psoriasis: Focusing on COVID‐19 course in psoriasis and the opinion on biologics in this setting

Ghoreishi Amin,

Khosravi,

Atefi

et al. 2023

Immunity Inflam & Disease

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IntroductionThis systematic review and meta‐analysis aims to investigate the mutual impact of COVID‐19 and psoriasis to inform clinical practice and future research.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta‐analysis protocol for systematic reviews and searched PubMed, Web of Science, Scopus, and Google Scholar until May 1, 2022. Eligibility criteria included full‐text articles in English reporting COVID‐19 treatment outcomes in psoriasis patients. Studies on animals, letters to editors, non‐English studies, and studies with no access to full articles were excluded. Search results were screened and data were extracted by two groups of reviewers with any discrepancies resolved by the senior author. The risk of bias was assessed using ROBINS‐I for nonrandomized studies. The hospitalization rate, Intensive Care Unit (ICU) admission rate, case fatality rate, odds ratios of COVID‐19 infection and hospitalization rate in psoriasis patients were extracted and analyzed using random effects analysis to calculate pooled prevalence and odds ratios, as well as to explore heterogeneity.ResultsWe found 1980 records from four databases and included 20 studies after screening and removing duplicates. These studies evaluated 185,000 psoriasis patients and included eight retrospective cohort studies, one case‐control study, three cross‐sectional studies, and eight case series studies. The impact of the COVID‐19 pandemic on psoriasis treatment and the outcome of COVID‐19 infection in psoriasis patients receiving different forms of treatment were evaluated. The pooled data from included studies showed that the incidence rate of COVID‐19 infection among psoriasis patients was 0.03% (confidence interval [CI]: 0.01–0.06), with a pooled odds ratio of 1.97 (CI: 0.69–5.60) compared to the general population. The hospitalization rate, ICU admission rate, and case fatality rate for psoriasis patients with COVID‐19 were 0.17 (CI: 0.10–0.31), 0.06 (CI: 0.06–0.46), and 0.02 (CI: 0.01–0.04), respectively. Additionally, psoriasis patients receiving systemic nonbiologic therapy had a pooled odds ratio of 2.32 (CI: 1.18–4.57) for hospitalization compared to those using biologic agents.ConclusionStudies have shown that biologic therapy for psoriasis did not increase the risk of hospitalization due to COVID‐19 infection and may have even offered some protection. Treatment adherence was higher in psoriasis patients receiving biologic therapies than those receiving conventional therapies. These findings suggest that psoriasis treatment did not negatively impact COVID‐19 infection and that treatment could be continued on a case‐by‐case basis during the pandemic.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 90%

A systematic review and meta‐analysis of investigating the mutual impact of COVID‐19 and psoriasis: Focusing on COVID‐19 course in psoriasis and the opinion on biologics in this setting

Ghoreishi Amin,

Khosravi,

Atefi

et al. 2023

Immunity Inflam & Disease

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“…Currently, there is no consensus on whether biological agents increase the risk of coronavirus infection 4 . Gargiulo et al reported a case series which supported the use of biologics in psoriasis patients with short disease duration and emphasized the safety of these treatments during the COVID‐19 pandemic 5 . Several studies have shown that the levels of circulating IL‐17 are elevated in the peripheral blood of COVID‐19 patients, which provided evidence to support treatment decisions for psoriasis patients treated with IL‐17 inhibitors during the COVID‐19 pandemic 6 .…”

Section: Discussionmentioning

confidence: 99%

Transition from secukinumab to adalimumab in COVID‐19‐induced psoriasis flare‐up treatment: A case report

Chen,

Qiu,

Chen

et al. 2023

Clinical Case Reports

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Key Clinical MessageCoronavirus disease 2019 (COVID‐19) is known to trigger systemic inflammation and elicit immune responses, which may disrupt the delicate balance of cytokines involved in psoriatic regulation. Compared to other therapies in dermatology, biologics used for immune‐mediated dermatological diseases have been more extensively studied during the COVID‐19 pandemic. Herein, we report a case of flare‐up of previously well‐controlled psoriasis shortly after infection with COVID‐19, with treatment transition from secukinumab to adalimumab.

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“…Systematic reviews regarding worsening of an existing disease or new onset of psoriasis show a preferable continuation of a stable medication instead of interrupting the antiinflammatory treatments. [41][42][43] However, this seems to be different in other regions of the world, as some reports from France, Turkey and Greece have shown higher numbers of patients (>16.9%) who discontinued their systemic therapy during the pandemic. 15,[44][45][46][47] Furthermore, Gisondi et al reported at the beginning of the pandemic no cases of deaths from COVID-related disease in an Italian population of patients with chronic plaque psoriasis undergoing biological therapy in comparison with the high number of deaths (IR1.6) in the general Italian population.…”

mentioning

confidence: 96%

Perception and Impact of COVID-19 Pandemic in Psoriasis Patients: Data from the German PsoBest and the CoronaBest Registries

Valencia López,

Stephan,

Meineke

et al. 2024

PTT

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Background: Limited data are available characterizing the impact of the SARS-CoV-2 pandemic on psoriasis care for patients in Germany.Objective: To analyze patient perception and impact of the pandemic on well-being and psoriasis management of German patients with moderate-to-severe psoriasis or psoriasis arthritis under systemic therapies. Methods: The CoronaBest registry captures events of SARS-CoV-2 infections and analyzes the impact of the pandemic on patients with psoriasis or psoriasis arthritis. In June 2020, and independently in February 2022, patients with psoriasis or psoriasis arthritis received a standardized questionnaire for current treatment, protective measures, well-being, and individual risks for COVID-19, among others. Results: Included were 4,194 patients in 2020 (mean age of 47.7 years and 41.8% women) and 4,818 patients in 2022 (mean age of 56.4 and 42.9% women). Treatment discontinuations were observed in 2.7% and 1.7% of patients in 2020 and 2022, respectively. In the vast majority of the cases (>92%), no additional measures were taken concerning the management of psoriasis treatments in either 2020 or 2022. Those patients with changes reported most frequently: telephone calls instead of face-to-face visits (80.2%, in 2020 vs 40.5% in 2022) or more frequent controls (27.1%, 2020 vs 22.0%, 2022). A majority (66.7%, 2020, and 70.6%, 2022) did not perceive the virus as a considerable threat. The proportion of patients feeling well informed about COVID-19 by physicians increased from 42.6% in 2020 to 51.8% in 2022. About 81.1% of patients in 2020 and 67.5% in 2022 stated that their overall personal condition was not affected due to the pandemic. Physicians attributed no special risk of contracting SARS-CoV-2 in most of the patients. Conclusion: A high rate of systemic treatment persistence and awareness of risks and protective measures indicate that health care for psoriasis largely followed current national and international recommendations during the COVID-19 pandemic.

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New-onset and flares of psoriasis after COVID-19 infection or vaccination successfully treated with biologics: a case series

Cited by 12 publications

References 14 publications

A systematic review and meta‐analysis of investigating the mutual impact of COVID‐19 and psoriasis: Focusing on COVID‐19 course in psoriasis and the opinion on biologics in this setting

A systematic review and meta‐analysis of investigating the mutual impact of COVID‐19 and psoriasis: Focusing on COVID‐19 course in psoriasis and the opinion on biologics in this setting

Transition from secukinumab to adalimumab in COVID‐19‐induced psoriasis flare‐up treatment: A case report

Perception and Impact of COVID-19 Pandemic in Psoriasis Patients: Data from the German PsoBest and the CoronaBest Registries

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