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Maynard N, Armstrong AW. The Impact of Immune-Modulating Treatments for Dermatological Diseases on the Risk of Infection with SARS-CoV-2 and Outcomes Associated with COVID-19 Illness. CURRENT DERMATOLOGY REPORTS 2023; 12:45-55. [PMID: 37304177 PMCID: PMC10068706 DOI: 10.1007/s13671-023-00385-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 04/05/2023]
Abstract
Purpose of Review Immune-modulating treatments are used in dermatology for a variety of conditions. The authors aim to review the data regarding the safety of these treatments during the COVID-19 pandemic, namely the risk of infection with SARS-CoV-2 and the outcomes associated with COVID-19-related illness. Recent Findings Several large-scale studies found no increased risk of COVID-19 infection for patients on TNF-α inhibitors, IL-17 inhibitors, IL-12/23 inhibitors, IL-23 inhibitors, dupilumab, and methotrexate. They also found that these patients did not have worse outcomes when infected with COVID-19. The data regarding JAK inhibitors, rituximab, prednisone, cyclosporine, mycophenolate mofetil, and azathioprine are more mixed. Summary Based on current research and guidelines from the American Academy of Dermatology and the National Psoriasis Foundation, dermatology patients on immune-modulating therapies can continue treatment during the COVID-19 pandemic when they are not infected with SARS-CoV-2. For patients who have COVID-19, guidelines encourage individualized assessment of the benefits and risks of continuing or temporarily withholding treatment.
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Affiliation(s)
- Nicole Maynard
- Keck School of Medicine of USC, 1975 Zonal Avenue, KAM 510, MC 9034, Los Angeles, CA 90089 USA
| | - April W. Armstrong
- Keck School of Medicine of USC, 1975 Zonal Avenue, KAM 510, MC 9034, Los Angeles, CA 90089 USA
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2
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Khanahmadi M, Khayatan D, Guest PC, Hashemian S, Abdolghaffari AH, Sahebkar A. The Relationship Between Psoriasis, COVID-19 Infection and Vaccination During Treatment of Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1412:339-355. [PMID: 37378776 DOI: 10.1007/978-3-031-28012-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Since the outbreak of the COVID-19 pandemic in December 2019, scientists worldwide have been looking for a way to control this global threat. One of the most successful and practical solutions has been the development and worldwide distribution of the COVID-19 vaccines. However, in a small percentage of cases, vaccination can lead to de novo development or exacerbation of immune or inflammatory conditions such as psoriasis. Due to the immunomodulatory nature of this disease, people affected by psoriasis and other related skin conditions have been encouraged to receive COVID-19 vaccines, which are immunomodulatory by nature. As such, dermatological reactions are possible in these patients, and cases of onset, exacerbation or change in the type of psoriasis have been observed in patients administered with COVID-19 vaccines. Considering the rarity and minor nature of some of these cutaneous reactions to COVID-19 vaccination, there is a general consensus that the benefits of vaccination outweigh the potential risks of experiencing such side effects. Nevertheless, healthcare workers who administer vaccines should be made aware of the potential risks and advise recipients accordingly. Furthermore, we suggest careful monitoring for potentially deleterious autoimmune and hyperinflammatory responses using point-of-care biomarker monitoring.
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Affiliation(s)
- Maryam Khanahmadi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Danial Khayatan
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Paul C Guest
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Somayyeh Hashemian
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hossein Abdolghaffari
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Medicinal Plants Research Center, Institute of Medicinal Plants, Karaj, Iran
- Department of Toxicology and Pharmacology, School of Pharmacy, and Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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3
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Liu M, Wang H, Liu L, Cui S, Huo X, Xiao Z, Zhao Y, Wang B, Zhang G, Wang N. Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis. Front Immunol 2022; 13:1046352. [PMID: 36389759 PMCID: PMC9648142 DOI: 10.3389/fimmu.2022.1046352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/10/2022] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) have brought great disaster to mankind, and there is currently no globally recognized specific drug or treatment. Severe COVID-19 may trigger a cytokine storm, manifested by increased levels of cytokines including interleukin-17 (IL-17), so a new strategy to treat COVID-19 may be to use existing IL-17 inhibitors, which have demonstrated efficacy, safety and tolerability in the treatment of psoriasis. However, the use of IL-17 inhibitors in patients with psoriasis during the COVID-19 pandemic remains controversial due to reports that IL-17 inhibitors may increase the risk of respiratory tract infections. OBJECTIVES The systematic review and meta-analysis aimed to evaluate the effect of IL-17 inhibitors on the risk of COVID-19 infection, hospitalization, and mortality in patients with psoriasis. METHODS Databases (including Embase, PubMed, SCI-Web of Science, Scopus, CNKI, and the Cochrane Library) were searched up to August 23, 2022, for studies exploring differences in COVID-19 outcomes between psoriasis patients using IL-17 inhibitors and those using non-biologics. Two authors independently extracted data and assessed the risk of bias in a double-blind manner. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and heterogeneities were determined by the Q test and I 2 statistic. And the numbers needed to treat (NNTs) were calculated to assess the clinical value of IL-17 inhibitors in preventing SARS-CoV-2 infection and treating COVID-19. RESULTS Nine observational studies involving 7,106 participants were included. The pooled effect showed no significant differences in the rates of SARS-CoV-2 infection (P = 0.94; I 2 = 19.5%), COVID-19 hospitalization (P = 0.64; I 2 = 0.0%), and COVID-19 mortality (P = 0.32; I 2 = 0.0%) in psoriasis patients using IL-17 inhibitors compared with using non-biologics. Subgroup analyses grouped by age and COVID-19 cases, respectively, revealed consistent results as above. Meanwhile, the pooled NNTs showed no significant differences between the two groups in the clinical value of preventing SARS-CoV-2 infection and treating COVID-19. CONCLUSION The use of IL-17 inhibitors in patients with psoriasis does not increase the risk of SARS-CoV-2 infection or worsen the course of COVID-19. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42022335195.
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Affiliation(s)
- Meitong Liu
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huijuan Wang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lu Liu
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Saijin Cui
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiangran Huo
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhuoyun Xiao
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yaning Zhao
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Wang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guoqiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Candidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, China
| | - Na Wang
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Skin Manifestations in Psoriatic and HS Patients in Treatment with Biologicals during the COVID-19 Pandemic. J Clin Med 2021; 10:jcm10245841. [PMID: 34945136 PMCID: PMC8703332 DOI: 10.3390/jcm10245841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/29/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic, a global public health emergency, has changed dermatology practice and daily routine in just under two years. Much has been written in the literature about COVID-19-associated skin manifestations. Nevertheless, much less has been written regarding skin manifestations in patients affected by severe immune-mediated skin diseases, e.g., psoriasis and hidradenitis suppurativa, undergoing biological treatment during the COVID-19 outbreak. Thus, the aim of this article is to provide the reader with an overview of the cutaneous manifestations during the COVID-19 pandemic in this subset of patients.
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Franchin G, Mantri N, Zahid M, Sun H, Gongati SR, Ronderos DM, Gadireddy S, Chilimuri S. Use of Monoclonal Antibodies Therapy for Treatment of Mild to Moderate COVID-19 in 4 Patients with Rheumatologic Disorders. Med Sci Monit 2021; 27:e934267. [PMID: 34819488 PMCID: PMC8631366 DOI: 10.12659/msm.934267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The use of monoclonal antibodies therapy (MAT) in early mild to moderate Coronavirus disease 2019 (COVID-19) has gained importance in recent times. However, there is limited information on the safety and efficacy of MAT in treating COVID-19 in patients with underlying rheumatologic diseases. Patients with rheumatologic diseases are usually on long-term corticosteroids and immunosuppressive therapy, which increases their risk for progressing to more severe forms of COVID-19. We report a case series of 4 patients with rheumatologic diseases who were treated with MAT for COVID-19. MATERIAL AND METHODS A retrospective observational study was conducted in our institution on patients with underlying rheumatological disorders who received MAT as per the EUA protocol of the FDA. RESULTS Two of the 4 patients were on immunosuppresive therapy at the time of receiving MAT. They recovered from COVID-19 without any adverse outcomes. No flare of underlying rheumatologic disease was noted. CONCLUSIONS MAT was observed to be a safe and effective therapy in 4 patients with rheumatological illnesses and COVID-19 treated at our hospital.
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Affiliation(s)
- Giovanni Franchin
- Division of Rheumatology, Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Nikhitha Mantri
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Maleeha Zahid
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Haozhe Sun
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Sudharsan R Gongati
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Diana M Ronderos
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Snigdha Gadireddy
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Sridhar Chilimuri
- Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
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Zou Y, Meng Z. Literature Overview of the IL-17 Inhibition from Psoriasis to COVID-19. J Inflamm Res 2021; 14:5611-5618. [PMID: 34754211 PMCID: PMC8570377 DOI: 10.2147/jir.s329252] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/07/2021] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic has posed a serious problem for drug anti-viral efficacy in combatting the cytokine storm triggered by SARS-CoV-2. From dermato-epidemiological studies conducted on psoriatic and other rheumatological patients, IL-17 inhibitors seem to attenuate or even prevent the cytokine storm and thus ICU referral. Furthermore, both in-vivo and in-vitro experiments suggest that IL-17 plays a key role in SARS-CoV-2 infection progression. Due to this evidence, we decided to summarize the literature findings on IL-17 inhibitors and COVID-19, maintaining psoriasis as the referral disease to better understand the extent of drug effects on the immune system. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/sbxhPoQS7do
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Affiliation(s)
- Yulin Zou
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan City, People's Republic of China
| | - Zudong Meng
- Department of Dermatology, Renmin Hospital, Hubei University of Medicine, Shiyan City, People's Republic of China
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7
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Keskin Y, Koz G, Nas K. What Has Changed in the Treatment of Psoriatic Arthritis After COVID-19? Eurasian J Med 2021; 53:132-136. [PMID: 34177297 DOI: 10.5152/eurasianjmed.2021.20222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Coronavirus disease 2019 is a respiratory infection caused by severe acute respiratory syndrome coronavirus 2. Coronavirus disease 2019 leads to the rapid activation of innate immune cells, particularly in patients with severe disease. Psoriatic arthritis is a heterogeneous chronic inflammatory disease characterized by the association of psoriasis and arthritis. Similar to those with other viruses, patients with psoriatic arthritis are at a significant risk of infection with severe acute respiratory syndrome coronavirus 2. Patients with psoriatic arthritis are immunosuppressed owing to immune dysregulation during the active disease period or owing to immunosuppressive drugs administered during remission, and they are prone to infections. The severe acute respiratory syndrome coronavirus 2 is a threat to millions of people globally owing to the decline in immunity and because a significant number of people develop severe illness. In the period of coronavirus disease 2019 pandemic, we briefly present recommendations for the treatment of psoriatic arthritis. In this review, we briefly address the management options and treatment recommendations for patients with psoriatic arthritis during and after the coronavirus disease 2019 pandemic in light of recent scientific publications.
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Affiliation(s)
- Yaşar Keskin
- Department of Physical Medicine and Rehabilitation, Bezmiâlem Foundation University, İstanbul, Turkey
| | - Gökhan Koz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology and Immunology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Kemal Nas
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology and Immunology, Sakarya University School of Medicine, Sakarya, Turkey
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8
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Ganguly S, Parthasaradhi A, Thomas J, Arora S, Kumar P, Pradhan S, Saraswat A, Singh V, Komeravalli H. Psoriasis Management During the COVID-19 Pandemic: Recommendations by SIG Psoriasis (IADVL Academy). Indian Dermatol Online J 2021; 12:58-65. [PMID: 33768023 PMCID: PMC7982007 DOI: 10.4103/idoj.idoj_685_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/18/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Satyaki Ganguly
- Department of Dermatology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | | | - Jayakar Thomas
- J. T. Skin Care Centre, Government Stanley Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Sandeep Arora
- Department of Dermatology, Army College of Medical Sciences and Base Hospital, Delhi Cantt, India
| | - Parimalam Kumar
- Department of Dermatology, Government Stanley Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Shekhar Pradhan
- Department of Dermatology, Government Medical College, Miraj, Maharashtra, India
| | - Abir Saraswat
- Indushree Skin Clinic, Lucknow, Uttar Pradesh, India
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9
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Banji D, Alqahtani SS, Banji OJ, Machanchery S, Shoaib A. Calming the inflammatory storm in severe COVID-19 infections: Role of biologics- A narrative review. Saudi Pharm J 2021; 29:213-222. [PMID: 33850422 PMCID: PMC8030716 DOI: 10.1016/j.jsps.2021.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/20/2021] [Indexed: 02/09/2023] Open
Abstract
The risk of Coronavirus infection continues, and the fear of resurgence indicates the lack of a successful therapeutic strategy. In severe COVID-19 infection, many immune cells and their products are involved, making management difficult. The abundant release of cytokines and chemokines in severe COVID-19 patients leads to profound hyper inflammation and the mobilization of immune cells, triggering the cytokine storm. The complications associated with the cytokine storm include severe respiratory distress, intravascular coagulation, multi-organ failure, and death. The enormous formation of interleukin (IL)-6 and hemopoietic factors such as granulocyte-macrophage colony-stimulating factor (GM-CSF) are implicated in the severity of the infection. Moreover, these inflammatory cytokines and factors signal through the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway causing the activation of cytokine-related genes. The neutralization of these proteins could be of therapeutic help in COVID-19 patients and could mitigate the risk of mortality. IL-6 antagonist, IL-6 receptor antagonists, GM-CSF receptor inhibitors, and JAK-STAT inhibitors are being investigated to prevent intense lung injury in COVID-19 patients and increase the chances of survival. The review focuses the role of IL-6, GM-CSF, and JAK-STAT inhibitors in regulating the immune response in severely affected COVID-19 patients.
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Affiliation(s)
- David Banji
- Department of Clinical Pharmacy, Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Saudi Arabia
| | - Saad S. Alqahtani
- Department of Clinical Pharmacy, Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Saudi Arabia
| | - Otilia J.F. Banji
- Department of Clinical Pharmacy, Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Saudi Arabia
| | - Shamna Machanchery
- Department of Clinical Pharmacy, Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Saudi Arabia
| | - Ambreen Shoaib
- Department of Clinical Pharmacy, Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Saudi Arabia
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Talamonti M, Galluzzo M, Chiricozzi A, Quaglino P, Fabbrocini G, Gisondi P, Marzano AV, Potenza C, Conti A, Parodi A, Piaserico S, Bardazzi F, Argenziano G, Rongioletti F, Stingeni L, Micali G, Loconsole F, Rossi MT, Bongiorno MR, Feliciani C, Rubegni P, Amerio P, Fargnoli MC, Pigatto P, Savoia P, Nisticò SP, Giustini S, Carugno A, Cannavo' SP, Rech G, Prignano F, Offidani A, Lombardo M, Zalaudek I, Bianchi L, Peris K. Characteristic of chronic plaque psoriasis patients treated with biologics in Italy during the COVID-19 Pandemic: Risk analysis from the PSO-BIO-COVID observational study. Expert Opin Biol Ther 2021; 21:271-277. [PMID: 33216643 DOI: 10.1080/14712598.2021.1853698] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
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.
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Affiliation(s)
- Marina Talamonti
- Dermatology Department, University of Rome "Tor Vergata" , Rome, Italy
| | - Marco Galluzzo
- Dermatology Department, University of Rome "Tor Vergata" , Rome, Italy
| | - Andrea Chiricozzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Dipartimento Scienze Mediche e Chirurgiche , Rome, Italy.,Università Cattolica del Sacro Cuore, Dermatologia , Rome, Italy
| | - Pietro Quaglino
- Medical Sciences Department, Dermatologic Clinic, University of Turin , Turin, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona , Verona, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan, Italy.,Department of Pathophysiology and Transplantation, Università Degli Studi di Milano , Milan, Italy
| | - Concetta Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi" Sapienza University of Rome - Polo Pontino , Rome, Italy
| | - Andrea Conti
- Dermatologic Unit, Department of Specialized Medicine, AOU Policlinico di Modena , Modena, Italy
| | - Aurora Parodi
- Clinica Dermatologica DiSSal Università di Genova, Ospedale-Policlinico San Martino IRCCS Genova , Italy
| | - Stefano Piaserico
- Dermatology Unit - Department of Medicine DIMED, University of Padova , Padova, Italy
| | - Federico Bardazzi
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna , Bologna, Italy
| | | | - Franco Rongioletti
- Section of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia , Perugia, Italy
| | | | - Francesco Loconsole
- Department of Biomedical Science and Human Oncology, Unit of Dermatology, University of Bari , Bari, Italy
| | - Maria Teresa Rossi
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia , Brescia, Italy
| | - Maria Rita Bongiorno
- Section of Dermatology, Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization, University of Palermo , Palermo, Italy
| | - Claudio Feliciani
- Department of Medicine and Surgery, Section of Dermatology, University of Parma , Parma, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena , Siena, Italy
| | - Paolo Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, G. D'Annunzio University , Chieti, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila , L'Aquila, Italy
| | - Paolo Pigatto
- Department of Biomedical, Surgical and Dental Sciences, Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, University of Milan , Milan, Italy
| | - Paola Savoia
- Department of Health Science, Dermatologic Clinic, University of Eastern Piedmont , Novara, Italy
| | - Steven Paul Nisticò
- Dermatology Unit, Department of Health Sciences, Università Magna Graecia , Catanzaro, Italy
| | - Sandra Giustini
- Department of Dermatology, 'Sapienza' University of Rome , Rome, Italy
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital , Bergamo, Italy
| | | | - Giulia Rech
- Division of Dermatology, Santa Chiara Hospital , Trento, Italy
| | - Francesca Prignano
- Dermatology Clinic, Department of Health Sciences, University of Florence , Florence, Italy
| | - Annamaria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region , Ancona, Italy
| | - Maurizio Lombardo
- Unit of Dermatological Diseases, ASST Sette Laghi, Ospedale di Circolo , Varese, Italy
| | - Iris Zalaudek
- Department of Dermatology, University of Trieste , Trieste, Italy
| | - Luca Bianchi
- Dermatology Department, University of Rome "Tor Vergata" , Rome, Italy
| | - Ketty Peris
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Dipartimento Scienze Mediche e Chirurgiche , Rome, Italy.,Università Cattolica del Sacro Cuore, Dermatologia , Rome, Italy
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11
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Patsatsi A, Kyriakou A. Impact of the COVID-19 pandemic on the course and management of chronic inflammatory immune-mediated skin diseases: What's the evidence? Clin Dermatol 2020; 39:52-55. [PMID: 33972053 PMCID: PMC7834280 DOI: 10.1016/j.clindermatol.2020.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, medical professionals have been overwhelmed by questions beyond the infection itself. In dermatology practice, clinicians have been facing difficulties about the management of chronic immune-mediated skin diseases. Issues arose, such as the grade of immunosuppression or immunomodulation, discontinuation or modification of treatment, and initiation of new treatments. In this comprehensive review, we present the current evidence about the course and management of chronic inflammatory dermatoses during the COVID-19 pandemic, focusing on psoriasis, atopic dermatitis, and hidradenitis suppurativa.
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Affiliation(s)
- Aikaterini Patsatsi
- 2nd Department of Dermatology, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece.
| | - Aikaterini Kyriakou
- 2nd Department of Dermatology, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
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Brazzelli V, Isoletta E, Barak O, Barruscotti S, Vassallo C, Giorgini C, Michelerio A, Tomasini CF, Musella V, Klersy C. Does therapy with biological drugs influence COVID-19 infection? Observational monocentric prevalence study on the clinical and epidemiological data of psoriatic patients treated with biological drugs or with topical drugs alone. Dermatol Ther 2020; 33:e14516. [PMID: 33169500 DOI: 10.1111/dth.14516] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/13/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022]
Abstract
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there has been an open debate on the impact of biological drugs used in the treatment of psoriasis. To define whether patients under treatment with biologics suffer from increased morbidity and mortality from COVID-19, compared to psoriatic patients treated only with topical drugs, we designed an observational monocentric prevalence study recording the personal and clinical data of psoriatic patients, with focus on the presentation of signs and symptoms related to COVID-19 in the period of time ranging from 1 January 2020 to 31 May 2020. A total of 180 patients were enrolled into two groups: 100 patients in the topical therapy group and 80 patients in the biological therapy group. No statistically significant difference was found between the groups regarding the prevalence of COVID-19 infection and symptoms at a bivariable analysis with adjustment for confounders. In conclusion, psoriatic patients under treatment with biologics do not seem to be more susceptible to COVID-19 compared to other psoriatic patients and we suggest not interrupting treatment with biological drugs, even in areas suffering from active outbreaks of the disease.
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Affiliation(s)
- Valeria Brazzelli
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Eugenio Isoletta
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Oren Barak
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Stefania Barruscotti
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Camilla Vassallo
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Chiara Giorgini
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Andrea Michelerio
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Carlo Francesco Tomasini
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy
| | - Valeria Musella
- Unit of Clinical Epidemiology and Biometrics, Scientific Direction, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Catherine Klersy
- Unit of Clinical Epidemiology and Biometrics, Scientific Direction, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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Thangaraju P, Venkatesan N, Sudha TYS, Venkatesan S, Thangaraju E. Role of Dupilumab in Approved Indications of COVID-19 Patient: an Efficacy-Based Nonsystematic Critical Analysis. ACTA ACUST UNITED AC 2020; 2:2126-2130. [PMID: 32935079 PMCID: PMC7483051 DOI: 10.1007/s42399-020-00510-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/30/2022]
Abstract
With many drugs being tried in the management and treatment of COVID-19, dupilumab is one such monoclonal antibody that has come under the limelight for its possible role as an adjunct therapy in COVID-19 position. There are isolated case reports and series that document a milder course of COVID-19 infection in patients who have already been on dupilumab therapy for treatment of conditions such as atopic dermatitis and chronic rhino-sinusitis with nasal polyp. There is also an ongoing debate regarding the continuation of biologicals in the COVID patient. In this article, a non-systematic critical analysis of dupilumab was performed to delve into this hypothesis further.
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Affiliation(s)
- Pugazhenthan Thangaraju
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Raipur, Raipur, Chhatisgarh India
| | - Nanditha Venkatesan
- All India Institute of Medical Sciences (AIIMS) Raipur, Raipur, Chhatisgarh India
| | - T Y Sree Sudha
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Raipur, Raipur, Chhatisgarh India
| | - Sajitha Venkatesan
- Department Of Microbiology, All India Institute of Medical Sciences (AIIMS) Raipur, Raipur, Chhatisgarh India
| | - Eswaran Thangaraju
- AKT memorial college of engineering and technology, Kallakurichi, Tamil Nadu India
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14
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De D, Pandhi D. Use of Immunosuppressants/Immunomodulators in Autoimmune/Inflammatory Dermatologic Diseases during COVID-19 Pandemic-General Recommendation Based on Available Evidence. Indian Dermatol Online J 2020; 11:526-533. [PMID: 32832437 PMCID: PMC7413441 DOI: 10.4103/idoj.idoj_414_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/05/2020] [Accepted: 06/19/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Dipankar De
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India E-mail:
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15
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Napolitano M, Patruno C, Ruggiero A, Nocerino M, Fabbrocini G. Safety of dupilumab in atopic patients during COVID-19 outbreak. J DERMATOL TREAT 2020; 33:600-601. [DOI: 10.1080/09546634.2020.1771257] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Maddalena Napolitano
- Department of Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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16
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Seirafianpour F, Sodagar S, Pour Mohammad A, Panahi P, Mozafarpoor S, Almasi S, Goodarzi A. Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review. Dermatol Ther 2020; 33:e13986. [PMID: 32639077 PMCID: PMC7362033 DOI: 10.1111/dth.13986] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023]
Abstract
COVID-19 had a great impact on medical approaches among dermatologist. This systematic review focuses on all skin problems related to COVID-19, including primary and secondary COVID-related cutaneous presentations and the experts recommendations about dermatological managements especially immunomodulators usage issues. Search was performed on PubMed, Scopus, Embase and ScienceDirect. Other additional resources were searched included Cochrane, WHO, Medscape and coronavirus dermatology resource of Nottingham university. The search completed on May 3, 2020. Three hundred seventy-seven articles assigned to the inclusion and exclusion groups. Eighty-nine articles entered the review. Primary mucocutaneous and appendageal presentations could be the initial or evolving signs of COVID-19. It could be manifest most commonly as a maculopapular exanthamatous or morbiliform eruption, generalized urticaria or pseudo chilblains recognized as "COVID toes" (pernio-like acral lesions or vasculopathic rashes). During pandemic, Non-infected non-at risk patients with immune-medicated dermatologic disorders under treatment with immunosuppressive immunomodulators do not need to alter their regimen or discontinue their therapies. At-risk o suspected patients may need dose reduction, interval increase or temporary drug discontinuation (at least 2 weeks). Patients with an active COVID-19 infection should hold the biologic or non-biologic immunosuppressives until the complete recovery occur (at least 4 weeks).
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Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Sogand Sodagar
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Arash Pour Mohammad
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Parsa Panahi
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Disease and Leishmaniasis Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Simin Almasi
- Department of Rheumatology, Rheumatology Research CenterFiroozgar Hospital, Iran University of Medical Sciences (IUMS)TehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasoul Akram Hospital, Iran University of Medical Sciences (IUMS)TehranIran
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