ABSTRACT
Introduction: There is very limited kn3e safety of COVID-19 vaccines in patients with psoriasis who are being treated with biological agents. We present our experience in 369 patients with moderate-to-severe psoriasis undergoing therapy with anti-IL agents who were vaccinated against SARS-CoV-2.Areas covered: None of the 369 patients referred to any serious adverse event related to vaccination against COVID-19, while about one-third reported mild adverse events similar to those seen in the general population that were resolved within 48 hours. No patient discontinued biological therapy to receive a COVID-19 vaccine.Expert opinion: Our observations provide evidence that COVID-19 vaccines can be considered safe in patients with moderate-to-severe psoriasis who are receiving anti-IL therapy.
Subject(s)
COVID-19 , Psoriasis , Biological Factors , COVID-19 Vaccines , Humans , Psoriasis/drug therapy , SARS-CoV-2ABSTRACT
BACKGROUND: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic. METHODS: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID-19 pandemic on the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were obtained at different timepoints by teledermatology during COVID-19 pandemic, when regular visits were not allowed due to sanitary restrictions. Disease severity was assessed by both physician- and patient-reported assessment scores evaluating itch intensity, sleep disturbances, and AD severity. RESULTS: A total of 1831 patients were included, with 1580/1831 (86.3%) continuing therapy during pandemic. Most patients were treated with dupilumab (86.1%, 1576/1831) that was interrupted in only 9.9% (156/1576) of cases, while systemic immunosuppressive compounds were more frequently withdrawn. Treatment interruption was due to decision of the patient, general practitioner, or dermatologist in 39.9% (114/286), 5.6% (16/286), and 30.1% (86/286) of cases, respectively. Fear of increased susceptibility to SARS-CoV-2 infection (24.8%, 71/286) was one of the main causes of interruption. Sixteen patients (0.9%) resulted positive to SARS-CoV-2 infection; 3 of them (0.2%) were hospitalized but no cases of COVID-related death occurred. CONCLUSIONS: Most AD patients continued systemic treatments during COVID pandemic and lockdown period, without high impact on disease control, particularly dupilumab-treated patients.
Subject(s)
COVID-19 , Dermatitis, Atopic , Adult , Communicable Disease Control , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/epidemiology , Humans , Italy/epidemiology , Pandemics , Registries , SARS-CoV-2ABSTRACT
Background: The susceptibility of patients with chronic plaque psoriasis and the risks or benefits related to the use of biological therapies for COVID-19 are unknown. Few data about prevalence, clinical course and outcomes of COVID-19 among psoriatic patients were reported. The aims of this study were 1) to assess the prevalence and severity of COVID-19 in psoriatic patients treated with biologic agents during the first phase of the emergency (22 February to 22 April 2020) in Italy, and 2) to report the clinical outcomes of patients who have been exposed to individuals with confirmed SARS-CoV-2 infection. Methods: Patients with moderate-to-severe chronic plaque psoriasis, aged ≥18 years and undergoing treatment with biologic agents as of 22 February 2020, were eligible to be included in PSO-BIO-COVID study. Demographic and clinical characteristics of patients using any biologic for psoriasis treatment between 22 February and 22 April 2020 were registered. Results: A total of 12,807 psoriatic patients were included in the PSO-BIO-COVID study. In this cohort 26 patients (0.2%) had a swab confirmation of SARS-CoV-2 infection. Eleven patients required hospitalization and two died. Conclusion: The incidence of COVID-19 observed in our cohort of psoriatic patients (0.2%) is similar to that seen in the general population (0.31%) in Italy. However, the course of the disease was mild in most patients. Biological therapies may likely lessen 'cytokine storm' of COVID-19, which sometimes lead to multiple organ failure, ARDS, and death.
Subject(s)
Biological Products/therapeutic use , Biological Therapy/methods , COVID-19/epidemiology , Psoriasis/drug therapy , Adult , Aged , Aged, 80 and over , Biological Products/pharmacology , COVID-19/diagnosis , Chronic Disease , Cohort Studies , Female , Humans , Incidence , Interleukin-17/antagonists & inhibitors , Italy/epidemiology , Male , Middle Aged , Pandemics , Psoriasis/diagnosis , Psoriasis/epidemiology , Receptors, Interleukin/antagonists & inhibitors , Risk Assessment/methods , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Young AdultABSTRACT
INTRODUCTION: In light of the current Covid-19 pandemic and the ongoing, extensive debate about the use of biological agents in psoriatic patients, we felt compelled to relate our experience in the use of secukinumab in the same cohort before and during the lockdown in Italy. Areas covered: Secukinumab was not discontinued, and there were no cases of confirmed infection with SARS-CoV-2 in this cohort. Expert opinion: In our practice, there is no evidence favoring the discontinuation of secukinumab in these patients. We also present a brief commentary on the use of biological agents in patients with moderate-to-severe plaque psoriasis.