Treatment of psoriasis with biologics in the early COVID‐19 pandemic: A study examining patient attitudes toward the treatment and disease course

Abstract

Background: Since March 2020, the coronavirus disease 2019 (COVID-19) pandemic has been ongoing all around the world with a wide range of clinical course including asymptomatic cases to severe and fatal respiratory tract disease. Patients on immunosuppressive treatments were predicted to be more susceptible to COVID-19. Aims: It was aimed to assess treatment continuity, the course of psoriasis and the course and clinical features of COVID-19 in patients treated with biological agents for psoriasis at the early initial period of COVID-19 pandemic. Patients/Methods: Patients treated with biological agents for psoriasis at our institute were contacted by phone between 1 and 10 July 2020 and fulfilled a questionnaire about their continuity to psoriasis treatments, clinical course of psoriasis, and any suspicion/diagnosis of COVID-19.Results: A total of 106 patients, 41 females and 65 males, were enrolled. Mean age of the patients was 46.1 ± 12.1 years (range: 19-77). Median duration of psoriasis was 18 years (min-max: 1 month-51 years). Twenty-four patients (22.6%) were using tumor necrosis alpha inhibitors (ETA:1, IFX:19, ADA:4), whereas 82 patients (77.4%) were using interleukin (IL) 12/23 or IL-17 inhibitors (UST:48, SECU:30, IXE:4).Seventy-six patients (71.7%) continued the treatment, whereas 30 patients (28.3%) interrupted the treatment voluntarily. Twenty out of 30 patients (66.6%) who interrupted the treatment had an exacerbation of psoriasis. None of the patients were diagnosed with COVID-19 in the study period. Conclusion: Patients with psoriasis who received biological therapy continued their treatment at a high rate during the early period of the COVID-19 pandemic. No COVID-19 diagnosis was made among patients whether they continued or discontinued treatment. Recurrence and exacerbation of psoriasis in a significant proportion of patients who interrupted treatment and absence of COVID-19 diagnosis in each group support the importance and safety of continuity of biological treatments for psoriasis in COVID-19 era.

Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey

“…Registry data suggest that biologics do not increase susceptibility to and/or severity of COVID-19. 8,12,20,23,24,[35][36][37][38] For example, our registry-based studies 12,13 and others 11,14,15 indicated that biologic use was associated with lower risk of COVID-19-related hospitalization compared with nonbiologic systemic therapies, albeit with potentially confounding shielding behaviour differences across treatment groups. 10 Larger-scale population-based research suggests no differences in COVID-19-related death in adults prescribed targeted immune-modifying therapy compared with those on standard systemic therapy.…”

“…[25][26][27][28] There may be different drivers of treatment nonadherence during this period compared with pre-pandemic, such as concerns surrounding own immunity, as suggested in our study and others. [18][19][20][22][23][24] As the COVID-19 pandemic evolves, it is important to understand and address pandemic-specific drivers of treatment nonadherence in psoriasis, to improve medication behaviours and subsequent patient outcomes.…”

“…Emerging research indicates that the COVID-19 pandemic may have negatively impacted adherence to systemic immune-modifying therapies in people with psoriasis, [17][18][19][20][21][22][23][24] with nonadherence ranging between 1.6% 20 and 68.5% 21 and considerable variation reported across systemic immune-modifying therapy types. 21 Global mental health has also been adversely affected in the COVID-19 pandemic.…”

Urinary Orosomucoid as a Potential Marker of Inflammation in Psoriasis Vulgaris

“…Other studies (23)(24)(25) found that most of psoriatic cases had gradual onset (96%) and 32% were progressive. The median duration of psoriasis was 18 years (26) .…”

Letter to the editor regarding article “Yalici‐Armagan B, Tabak GH, Dogan‐Gunaydin S, Gulseren D, Akdogan N, Atakan N. Treatment of psoriasis with biologics in the early COVID‐19 pandemic: A study examining patient attitudes toward the treatment and disease course. J Cosmet Dermatol. 2021;00:1–5”

“…We read with great interest the article published by Yalici-Armagan et al 1 titled "Treatment of psoriasis with biologics in the early COVID-19 pandemic: A study examining patient attitudes toward the treatment and disease course" reporting that 30 out of 106 patients (28.3%) autonomously discontinued biologic therapy for psoriasis during COVID-19 pandemic, frequently experiencing disease worsening (20/30, 66.7%).…”