Psoriasis, biologic therapy, and the pandemic of the 21st century

Nogueira, Miguel; Vender, Ronald; Torres, Tiago

doi:10.7573/dic.2020-4-10

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Such statements are in line with the most recent findings about the topic, as shown from the analysis run in two high-epidemic areas ( n = 159 patients at Bergamo Hospital and n = 139 patients at Lecco Hospital, both treated with biologics), and so encourage adherence to biologics given the well-known effects at withdrawal such as flares and resistance to further treatments [2-5].…”

supporting

confidence: 81%

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

et al. 2020

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supporting

confidence: 81%

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

et al. 2020

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“…Despite early enthusiasm for its use, hydroxychloroquine is no longer considered to be an effective therapy for patients with COVID-19 [ 77 ]. Patients who take maintenance immunosuppressive therapy for management of psoriasis or rheumatic diseases such as rheumatoid arthritis (RA) should follow the advice not to discontinue their use of biologic agents prematurely [ 78 ]. Tumour necrosis factor-alpha inhibitors are not believed to increase the risk of viral infection but may have a therapeutic effect in patients with COVID-19 [ 79 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

Flaherty

Hession

Liew

et al. 2020

Trop Dis Travel Med Vaccines

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Background: A high burden of severe disease and death from the coronavirus disease 2019 (COVID-19) has been consistently observed in older patients, especially those with pre-existing medical co-morbidities. The global pandemic lockdown has isolated many patients with chronic illnesses from their routine medical care. This narrative review article analyses the multitude of issues faced by individuals with underlying medical conditions during the COVID-19 pandemic. Methods: Sources for this publication were identified through searches of PubMed for articles published between 31st December 2019 and 4th June 2020, using combinations of search terms. Guidelines and updates from reputable agencies were also consulted. Only articles published in the English language were included. Results: The volume of literature on COVID-19 continues to expand, with 17,845 articles indexed on PubMed by 4th June 2020, 130 of which were deemed particularly relevant to the subject matter of this review. Older patients are more likely to progress to severe COVID-19 disease requiring intensive care unit (ICU) admission. Patients with preexisting cardiovascular disease, especially hypertension and coronary heart disease, are at greatly increased risk of developing severe and fatal COVID-19 disease. A controversial aspect of the management of COVID-19 disease has been the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Obese COVID-19 patients are more likely to require complex ICU management. Putative mechanisms of increased COVID-19 disease severity in diabetes include hyperglycaemia, altered immune function, sub-optimal glycaemic control during hospitalisation, a pro-thrombotic and pro-inflammatory state. Patients with mental health disorders are particularly vulnerable to social isolation, and this has been compounded by the suspension of non-emergency care in hospitals around the world, making it difficult for patients with chronic mental illness to attend outpatient appointments.

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“…2 , 7 , 11 , 14 , 15 Interestingly, COVID-19 seems to induce an immune event known as a ‘cytokine storm’, an inappropriate host-inflammatory response that seems to be even more exacerbated in patients with more severe disease. 10 , 15 Therefore, several targeted therapies – some of them also used in psoriasis, such as ixekizumab or adalimumab – have been introduced in clinical trials to evaluate their effectiveness in treating patients with SARS-CoV-2 infection. 15 …”

Section: Discussionmentioning

confidence: 99%

Dermatologists’ attitude towards psoriasis treatment during the COVID-19 pandemic

Torres¹,

Pereira²,

Lopes³

et al. 2021

DIC

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Background The COVID-19 pandemic introduced new challenges in several dimensions in healthcare services. Herein, we describe the real-life strategies and therapeutic options adopted by dermatologists regarding their patients with psoriasis being treated with or with an indication for systemic therapy during the first COVID-19 lockdown period in Portugal. Methods The study involves a web-based survey on the clinical management of systemic therapy for psoriasis during the COVID-19 pandemic administered to Portuguese dermatologists. The survey consisted of 55 questions (4 open-ended questions; 51 closed-ended questions), grouped into 6 sections. Results A total of 60 dermatologists voluntarily participated in this survey. Nearly 63% of the participants opted for suspending biologics during the COVID-19 lockdown period and 23.3% increased the time between drug administrations. Eighty percent of the participants agreed that biologics did not change the probability of acquiring COVID-19 and 58.4% believed that these drugs decreased or did not change the severity of the disease. Approximately one-third of the participants opted not to prescribe a biological agent in patients despite clinical indication over the duration of the pandemic. Nearly 25% of the participants opted for suspending traditional immunosuppressant administration. Virtual appointments were an option for 93.3% of the participants. Conclusion The COVID-19 pandemic has significantly affected the management of patients with psoriasis being treated with or with an indication for systemic therapy. Some of the decisions made during the first lockdown period were contrary to what we know today. These decisions might have had a significant impact on patients’ quality of life and on future therapeutic success. An adequate interpretation and analysis of the available data will be extremely important to an insightful adaptation of the clinical practice in future confinement or restrictive scenarios.

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Psoriasis, biologic therapy, and the pandemic of the 21st century

Cited by 7 publications

References 13 publications

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

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

COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

Dermatologists’ attitude towards psoriasis treatment during the COVID-19 pandemic

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