1
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Nahm WJ, Liang SE, Ho RS. The immunogenicity of hepatitis B vaccine in psoriasis patients and by treatment type: A retrospective cohort study. J Eur Acad Dermatol Venereol 2024. [PMID: 38853625 DOI: 10.1111/jdv.20135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/08/2024] [Indexed: 06/11/2024]
Affiliation(s)
- William J Nahm
- New York University Grossman School of Medicine, New York, New York, USA
| | - Sydney E Liang
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| | - Roger S Ho
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
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2
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Toplu SA, Altunisik N. Comment on 'Immune response to COVID-19 mRNA vaccination in patients with psoriasis undergoing treatment with biologics'. Clin Exp Dermatol 2024; 49:394. [PMID: 37966357 DOI: 10.1093/ced/llad392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 11/16/2023]
Affiliation(s)
| | - Nihal Altunisik
- Department of Dermatology, Inonu University, Malatya, Turkey
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3
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Shan DM, Chandy RJ, Fultz A, Sanders JW, Feldman SR. Live vaccinations in dermatology for immunosuppressed patients: a narrative review. Arch Dermatol Res 2024; 316:96. [PMID: 38430244 DOI: 10.1007/s00403-024-02827-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/06/2023] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
Given the higher susceptibility to infectious disease in patients receiving immunosuppressive therapies for inflammatory dermatologic conditions, immunization is important in this population. While live vaccines protect against life-threatening diseases, they can be harmful in immunosuppressed patients given the risk of replication of the attenuated pathogen and adverse reactions. The utilization of live vaccines in immunosuppressed patients depends on multiple factors such as the vaccine and therapy regimen. To provide an overview of evidence-based recommendations for the use of live vaccines in patients receiving immunosuppressive therapies for dermatological conditions. A literature search of the PubMed database was performed using keywords live vaccine, live-attenuated vaccine, dermatology, immunosuppressed, and immunocompromised, and specific immunosuppressive therapies: corticosteroids, glucocorticoids, methotrexate, azathioprine, cyclosporine, mycophenolate mofetil, biologics. Relevant articles written in English were included. Using these keywords, 125 articles were reviewed, of which 28 were ultimately selected. Recommendations for live vaccines can be determined on a case-by-case basis. Measles, mumps, rubella, varicella (MMRV) vaccines may be safely administered to patients on low-dose immunosuppressive agents while the yellow fever vaccine is typically contraindicated. It may be safe to administer live MMRV boosters to children on immunosuppressive therapies and the live herpes zoster vaccine to patients on biologics. Given poor adherence to immunization guidelines in immunosuppressed patients, dermatologists have a critical role in educating patients and general practitioners regarding live vaccines. By reviewing a patient's vaccination history and following immunization guidelines prior to initiating immunosuppressive therapies, physicians can mitigate morbidity and mortality from vaccine-preventable diseases.
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Affiliation(s)
- Divya M Shan
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Rithi J Chandy
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Andrew Fultz
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - John W Sanders
- Department of Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Dermatology, University of Southern Denmark, Odense, Denmark
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4
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Sacchelli L, Filippi F, Balato A, Balestri R, Bellinato F, Bernardini N, Bianchi L, Burlando M, Campanati A, Chessa MA, Corazza M, Di Cesare A, Di Lernia V, Diotallevi F, Esposito M, Fargnoli MC, Gisondi P, Giunta A, Hansel K, Magnano M, Megna M, Odorici G, Prignano F, Potenza C, Rech G, Rovesti M, Ruggiero A, Satolli F, Stingeni L, Gibertoni D, Bardazzi F. PsoBioVax: A multicentric Italian case-control study of the immunological response to anti-SARS-CoV-2 vaccine among psoriatic patients under biological therapy. J Eur Acad Dermatol Venereol 2024; 38:e215-e218. [PMID: 38059550 DOI: 10.1111/jdv.19662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023]
Affiliation(s)
- L Sacchelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Filippi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Balestri
- Division of Dermatology, Psoriasis Outpatient Service, APSS, Trento, Italy
| | - F Bellinato
- Dipartimento di Medicina Sezione Di Dermatologia Università di Verona, Verona, Italy
| | - N Bernardini
- Department of Medico-Surgical Sciences and Biotechnologies Faculty of Pharmacy and Medicine Sapienza University of Rome - Polo Pontino (ASL Latina), Latina, Italy
| | - L Bianchi
- Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - M Burlando
- Department of Dermatology, DISSAL University of Genoa, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - A Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - M A Chessa
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Corazza
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - A Di Cesare
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - V Di Lernia
- Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - F Diotallevi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - M Esposito
- Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Dermatology Unit, Ospedale San Salvatore, L'Aquila, Italy
| | - M C Fargnoli
- Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Dermatology Unit, Ospedale San Salvatore, L'Aquila, Italy
| | - P Gisondi
- Dipartimento di Medicina Sezione Di Dermatologia Università di Verona, Verona, Italy
| | - A Giunta
- Dermatology, Fondazione PTV Policlinico Tor Vergata, Rome, Italy
| | - K Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - M Magnano
- Division of Dermatology, Psoriasis Outpatient Service, APSS, Trento, Italy
| | - M Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - G Odorici
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - F Prignano
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - C Potenza
- Department of Medico-Surgical Sciences and Biotechnologies Faculty of Pharmacy and Medicine Sapienza University of Rome - Polo Pontino (ASL Latina), Latina, Italy
| | - G Rech
- Division of Dermatology, Psoriasis Outpatient Service, APSS, Trento, Italy
| | - M Rovesti
- Dermatologic Unit, Ospedale "Guglielmo da Saliceto", Piacenza, PC, Italy
| | - A Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - F Satolli
- UOC Dermatologia, University of Parma, Parma, Italy
| | - L Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - D Gibertoni
- Research and Innovation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - F Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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5
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Narbutt J, Żuber Z, Lesiak A, Bień N, Szepietowski JC. Vaccinations in Selected Immune-Related Diseases Treated with Biological Drugs and JAK Inhibitors-Literature Review and Statement of Experts from Polish Dermatological Society. Vaccines (Basel) 2024; 12:82. [PMID: 38250895 PMCID: PMC10820194 DOI: 10.3390/vaccines12010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
The growing use of biological drugs in immune-mediated chronic diseases has undoubtedly revolutionized their treatment. Yet, the topic of vaccinations in this group of patients still raises many concerns and implies many therapeutic problems that require discussion and standardization of management. The aim of this literature review is to present current knowledge regarding safety and efficacy of vaccinations in dermatological and rheumatological patients treated with biological drugs and JAK inhibitors. Additionally, this article provides recommendation from experts of the Polish Dermatological Society about proper use of vaccinations during therapy with biologics. Generally, all live attenuated vaccines are contraindicated during immunosuppressive/immunomodulatory therapy. If there is need, they should be administered long enough prior to the therapy or after cessation. Yet, inactivated vaccines mostly can be safely used, but the problem in this case is the effectiveness of the vaccination. Most studies report that the immune response in patients on biologics after administration of different inactivated vaccines is similar to or even better than in the control group. Thus, the importance of vaccination among patients on biologics must be emphasized to reduce omissions and the fear of possible side effects or insufficient post-vaccination response.
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Affiliation(s)
- Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (A.L.)
| | - Zbigniew Żuber
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland;
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (A.L.)
| | - Natalia Bień
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (A.L.)
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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6
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Stinco G, Errichetti E, Figini M, Guglielmo A, Fazzi B, Quartuccio L, Zabotti A, De Vita S, Isola M, De Martino M, Rossi S, Lucis R, Fabris M, Beltrami AP, Curcio F, D'Aurizio F. Seroconversion and neutralizing antibodies production after completion of Pfizer-BioNTech BNT 162b2 vaccination scheme among psoriatic patients receiving biological or topical treatment: A prospective observational cohort study. J Eur Acad Dermatol Venereol 2023; 37:e447-e448. [PMID: 36477939 PMCID: PMC9877773 DOI: 10.1111/jdv.18809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Giuseppe Stinco
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Enzo Errichetti
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Matteo Figini
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alba Guglielmo
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Benedetta Fazzi
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Luca Quartuccio
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alen Zabotti
- Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Salvatore De Vita
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Rheumatology Clinic, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Miriam Isola
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Division of Medical Statistics, University of Udine, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, University of Udine, Udine, Italy
| | - Silvia Rossi
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Riccardo Lucis
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Antonio Paolo Beltrami
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Francesco Curcio
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Federica D'Aurizio
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
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7
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Aryanian Z, Balighi K, Afshar ZM, Zamanian MH, Razavi Z, Hatami P. COVID vaccine recommendations in dermatologic patients on immunosuppressive agents: Lessons learned from pandemic. J Cosmet Dermatol 2022; 21:6568-6573. [PMID: 36214611 PMCID: PMC9874417 DOI: 10.1111/jocd.15448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/08/2022] [Accepted: 10/06/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Since SARS-CoV2 vaccines were approved without enough long-term monitoring due to emergent situations, some issues have been raised about timing and protocol of receiving them by patients treated by different immunosuppressive agents. AIM AND METHOD Here, we present different aspects of SARS-CoV-2 vaccination in such patients in the field of dermatology. RESULT In brief, SARS-CoV-2 vaccination is recommended in all dermatologic patients, regardless of their disorders and therapeutic regimens. Nevertheless, special considerations should be given to the immunosuppressive therapy and its association with vaccination timing due to the decreased immunogenicity of vaccines in this setting. CONCLUSION Novel biologic immunotherapies are advantageous over conventional systemic therapies not only in their safety and selective functions but also in this aspect that many of them do not affect vaccines immunogenicity.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran,Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran,Department of Infectious Disease, School of Medicine, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Mohammad Hossein Zamanian
- Department of Infectious Disease, School of Medicine, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Zahra Razavi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
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8
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Marovt M, Deželak P, Ekart R, Marko PB. Immune response to SARS-CoV-2 mRNA vaccine in psoriasis patients treated with biologics. Clin Exp Dermatol 2022; 47:2041-2043. [PMID: 35938595 PMCID: PMC9538036 DOI: 10.1111/ced.15347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Maruška Marovt
- Department of Dermatovenerology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Petra Deželak
- National Laboratory of Health, Environment and Food, Prvomajska ulica 1, 2000, Maribor, Slovenia
| | - Robert Ekart
- Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Pij B Marko
- Department of Dermatovenerology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
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9
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Vaccination, Risk Factors and Outcomes of COVID-19 Infection in Patients with Psoriasis—A Single Centre Real-Life Experience from Eastern Slovakia. Viruses 2022; 14:v14081646. [PMID: 36016267 PMCID: PMC9415362 DOI: 10.3390/v14081646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/22/2022] Open
Abstract
Coronavirus disease (COVID-19) represents a threat for people with immune-mediated diseases. It seems that patients with psoriasis appear to have a similar SARS-CoV-2 infection rate as the general population. Our study aimed to identify factors associated with contracting COVID-19 and determining the severity of COVID-19 among psoriatic patients in a real practice setting. We conducted a cross-sectional study with 379 respondents. About one-quarter (n = 78; 25.8%) of the respondents who provided information on their COVID-19 (n = 302) status had contracted COVID-19. Most variables tested for their effect on getting COVID-19 proved to be statistically insignificant, except education, age and gender. Our study proved the protective effect of vaccination, especially the third dose, against the COVID-19 outcome. From all the potential variables, we found that non-Roma ethnicity increased the chance of being vaccinated at least once by 2.6-fold. Patients with a longer psoriasis duration had a higher chance of being vaccinated. We consider biological treatment of psoriasis safe during COVID-19. Vaccination of patients was a statistically significant protector against COVID-19. It is important to point out that only three doses of vaccine decreased with statistical significance the chance of getting the illness. Our findings should be confirmed on larger samples in further studies.
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10
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Low Pneumococcal Vaccination among Patients with Psoriasis in Germany: Results from Vac-Pso. Vaccines (Basel) 2022; 10:vaccines10071005. [PMID: 35891172 PMCID: PMC9315583 DOI: 10.3390/vaccines10071005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
While suboptimal pneumococcal vaccination rates have been reported in immunosuppressed patients with rheumatic diseases, data for patients with psoriasis (PsO) or atopic dermatitis (AD) are scarce. Pneumococcal vaccination in Germany is recommended in patients with certain comorbidities, immunosuppression, and/or aged 60 years or above. The aim of this multicenter cross-sectional study was to investigate the pneumococcal vaccination rate in patients with PsO compared to patients with AD and to evaluate patient perceptions. All patients completed a questionnaire on vaccination status and perceptions, patient and disease characteristics, as well as comorbidity. Medical records and vaccination certificates were reviewed. Over the whole cohort (n = 327 PsO (41.9% female), n = 98 AD (42.9% female)), 83.8% and 42.9% of PsO and AD patients, respectively, had an indication for pneumococcal vaccination due to immunosuppressive treatment. The pneumococcal vaccination rate was 14.4% and 10.2% in PsO and AD patients, respectively. The vaccination rate depended significantly on age, working status and presence of psoriatic arthritis. The most common reason for nonvaccination was lacking recommendation by physicians. Higher awareness, particularly for vaccination indication due to immunosuppression among dermatologists, general physicians, and patients, is warranted.
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11
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Actualización práctica de las recomendaciones del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología (GPS) para el tratamiento de la psoriasis con terapia biológica. Parte 2 «Manejo de poblaciones especiales, pacientes con comorbilidad y gestión del riesgo». ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:583-609. [DOI: 10.1016/j.ad.2022.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/26/2022] [Indexed: 12/19/2022] Open
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12
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Carrascosa JM, Puig L, Romero IB, Salgado-Boquete L, Del Alcázar E, Lencina JJA, Moreno D, de la Cueva P. [Translated article] Practical Update of the Guidelines Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPs) on the Treatment of Psoriasis With Biologic Agents: Part 2-Management of Special Populations, Patients With Comorbid Conditions, and Risk. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T583-T609. [PMID: 35748004 DOI: 10.1016/j.ad.2022.01.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/26/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Since its inception, the Psoriasis Group (GPs) of the Spanish Academy of Dermatology and Venereology (AEDV) has worked to continuously update recommendations for the treatment of psoriasis based on the best available evidence and incorporating proposals arising from and aimed at clinical practice. An updated GPs consensus document on the treatment of moderate to severe psoriasis was needed because of changes in the treatment paradigm and the approval in recent years of a large number of new biologic agents. METHODOLOGY The consensus document was developed using the nominal group technique complemented by a scoping review. First, a designated coordinator selected a group of GPs members for the panel based on their experience and knowledge of psoriasis. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. The coordinator then drew up a set of proposed recommendations, which were discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. RESULTS The present guidelines include updated recommendations on assessing the severity of psoriasis and criteria for the indication of systemic treatment. They also include general principles for the treatment of patients with moderate to severe psoriasis and define treatment goals for these patients as well as criteria for the indication and selection of initial and subsequent therapies Practical issues, such as treatment failure and maintenance of response, are also addressed.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, Spain.
| | - L Puig
- Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - I B Romero
- Departamento de Dermatología, Hospital General Universitario de Alicante-ISABIAL - Universidad Miguel Hernández de Elche, Alicante, Spain
| | - L Salgado-Boquete
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - E Del Alcázar
- Departamento de Dermatología, Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, Spain
| | - J J A Lencina
- Servicio de Dermatología, Hospital Universitario Vega Baja, Alicante, Spain
| | - D Moreno
- Departamento de Dermatología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
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13
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Norimatsu Y, Norimatsu Y. A severe case of Trichophyton rubrum-caused dermatomycosis exacerbated after COVID-19 vaccination that had to be differentiated from pustular psoriasis. Med Mycol Case Rep 2022; 36:19-22. [PMID: 35299937 PMCID: PMC8917097 DOI: 10.1016/j.mmcr.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/22/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yuta Norimatsu
- Department of Dermatology, University of Tokyo Graduate School of Medicine, 113-8655, 7-3-1,Hongo, Bunkyo-ku, Tokyo, Japan
- Department of Dermatology, Ageo Daiichi Clinic for Internal Medicine and Pediatrics, 362-0064, 845-1 Koshikidani, Ageo, Saitama, Japan
- Corresponding author. Department of Dermatology, University of Tokyo Graduate School of Medicine, 113-8655, 7-3-1,Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Yurie Norimatsu
- Department of Dermatology, Ageo Daiichi Clinic for Internal Medicine and Pediatrics, 362-0064, 845-1 Koshikidani, Ageo, Saitama, Japan
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14
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Parthasaradhi A, Ganguly S, Kar BR, Thomas J, Neema S, Tahiliani S, Sathishkumar D, Parasramani SG, Chalam KV, Komeravalli H. Coronavirus disease 2019 vaccination in patients with psoriasis: A position statement from India by SIG psoriasis (IADVL Academy). Indian J Dermatol Venereol Leprol 2022; 88:286-290. [PMID: 35434988 DOI: 10.25259/ijdvl_773_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/01/2021] [Indexed: 11/04/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic has affected every sphere of life including management of psoriasis. The availability of COVID-19 vaccines has given rise to hope and at the same time some apprehensions as well. With the general population becoming eligible for vaccination, there is some confusion, on the eligibility of patients with different medical conditions and patients on immunosuppressive or immunomodulating medications for COVID-19 vaccination. Dermatologists treating psoriasis patients frequently face questions from them, whether they can undergo coronavirus disease 2019 vaccination. A PUBMED search was performed using the following strategy: 'COVID-19' AND 'Vaccine' AND 'Psoriasis'. We also performed a PUBMED search using the following strategy: 'SARS-CoV-2' AND 'Vaccine' AND 'Psoriasis'. All articles irrespective of language and publication date were included to arrive at this position statement. This position statement deals with the safety, eligibility and modifications of treatment, if needed among psoriasis patients with regards to the coronavirus disease 2019 vaccines currently available in India.
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Affiliation(s)
| | - Satyaki Ganguly
- Department of Dermatology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Bikash Ranjan Kar
- Department of Dermatology, IMS and SUM Hospital, Sikshya "O" Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Jayakar Thomas
- Department of Research, Chettinad Academy of Research and Education (Deemed to be University), Kelambakkam, Chennai, Tamil Nadu, India
| | - Shekhar Neema
- Department of Dermatology, Armed Forces Medical College, Pune, India
| | - Sushil Tahiliani
- Department of Dermatology, Hinduja Hospital, Mumbai, Maharashtra, India
| | | | | | - K Venkata Chalam
- Department of Dermatology, Andhra Medical College, Vishakhapatnam, Andhra Pradesh, India
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15
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Otani IM, Lehman HK, Jongco AM, Tsao LR, Azar AE, Tarrant TK, Engel E, Walter JE, Truong TQ, Khan DA, Ballow M, Cunningham-Rundles C, Lu H, Kwan M, Barmettler S. Practical guidance for the diagnosis and management of secondary hypogammaglobulinemia: A Work Group Report of the AAAAI Primary Immunodeficiency and Altered Immune Response Committees. J Allergy Clin Immunol 2022; 149:1525-1560. [PMID: 35176351 DOI: 10.1016/j.jaci.2022.01.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/31/2021] [Accepted: 01/21/2022] [Indexed: 11/17/2022]
Abstract
Secondary hypogammaglobulinemia (SHG) is characterized by reduced immunoglobulin levels due to acquired causes of decreased antibody production or increased antibody loss. Clarification regarding whether the hypogammaglobulinemia is secondary or primary is important because this has implications for evaluation and management. Prior receipt of immunosuppressive medications and/or presence of conditions associated with SHG development, including protein loss syndromes, are histories that raise suspicion for SHG. In patients with these histories, a thorough investigation of potential etiologies of SHG reviewed in this report is needed to devise an effective treatment plan focused on removal of iatrogenic causes (eg, discontinuation of an offending drug) or treatment of the underlying condition (eg, management of nephrotic syndrome). When iatrogenic causes cannot be removed or underlying conditions cannot be reversed, therapeutic options are not clearly delineated but include heightened monitoring for clinical infections, supportive antimicrobials, and in some cases, immunoglobulin replacement therapy. This report serves to summarize the existing literature regarding immunosuppressive medications and populations (autoimmune, neurologic, hematologic/oncologic, pulmonary, posttransplant, protein-losing) associated with SHG and highlights key areas for future investigation.
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Affiliation(s)
- Iris M Otani
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, UCSF Medical Center, San Francisco, Calif.
| | - Heather K Lehman
- Division of Allergy, Immunology, and Rheumatology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Artemio M Jongco
- Division of Allergy and Immunology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY
| | - Lulu R Tsao
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, UCSF Medical Center, San Francisco, Calif
| | - Antoine E Azar
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore
| | - Teresa K Tarrant
- Division of Rheumatology and Immunology, Duke University, Durham, NC
| | - Elissa Engel
- Division of Hematology and Oncology, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Jolan E Walter
- Division of Allergy and Immunology, Johns Hopkins All Children's Hospital, St Petersburg, Fla; Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa; Division of Allergy and Immunology, Massachusetts General Hospital for Children, Boston
| | - Tho Q Truong
- Divisions of Rheumatology, Allergy and Clinical Immunology, National Jewish Health, Denver
| | - David A Khan
- Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas
| | - Mark Ballow
- Division of Allergy and Immunology, Morsani College of Medicine, Johns Hopkins All Children's Hospital, St Petersburg
| | | | - Huifang Lu
- Department of General Internal Medicine, Section of Rheumatology and Clinical Immunology, The University of Texas MD Anderson Cancer Center, Houston
| | - Mildred Kwan
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill
| | - Sara Barmettler
- Allergy and Immunology, Massachusetts General Hospital, Boston.
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16
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Aryanian Z, Balighi K, Hatami P, Goodarzi A, Mohandesi NA, Afshar ZM. SARS-CoV-2 vaccination and practical points in psoriasis patients: a narrative review. Dermatol Ther 2022; 35:e15430. [PMID: 35261123 PMCID: PMC9111853 DOI: 10.1111/dth.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/29/2022]
Abstract
SARS‐CoV2 vaccines were approved without long‐term monitoring due to emergent situations. This has raised some issues about timing and protocol of receiving vaccines in specific situations including patients with chronic inflammatory disorders such as psoriasis. Here, we present different aspects of SARS‐CoV‐2 infection and vaccination in psoriasis patients and aim to provide solutions to overcome the potential challenges. In brief, the benefits of vaccination outweigh the potential risk; vaccine‐triggered de novo or flares of psoriasis is uncommon. As such, all psoriasis patients, especially those receiving systemic treatments including anti tumor necrosis factor agents, are strongly recommended to get SARS‐CoV‐2 vaccines. It is recommended that new immunosuppressive/immunomodulatory therapies be initiated at least 1 week after the second SARS‐CoV‐2 vaccine dose, if possible. In addition, in severe and active forms of psoriasis, it is better to delay vaccination until stabilization of the disease.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran, Iran.,Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran, Iran.,Department of Dermatology, School of Medicine Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasoul-e- Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah, University of Medical Sciences, Kermanshah, Iran
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17
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Garcillán B, Salavert M, Regueiro JR, Díaz-Castroverde S. Response to Vaccines in Patients with Immune-Mediated Inflammatory Diseases: A Narrative Review. Vaccines (Basel) 2022; 10:297. [PMID: 35214755 PMCID: PMC8877652 DOI: 10.3390/vaccines10020297] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/26/2022] [Accepted: 02/13/2022] [Indexed: 12/28/2022] Open
Abstract
Patients with immune-mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis and inflammatory bowel disease, are at increased risk of infection. International guidelines recommend vaccination to limit this risk of infection, although live attenuated vaccines are contraindicated once immunosuppressive therapy has begun. Biologic therapies used to treat IMIDs target the immune system to stop chronic pathogenic process but may also attenuate the protective immune response to vaccines. Here, we review the current knowledge regarding vaccine responses in IMID patients receiving treatment with biologic therapies, with a focus on the interleukin (IL)-12/23 inhibitors. B cell-depleting therapies, such as rituximab, strongly impair vaccines immunogenicity, and tumor necrosis factor (TNF) inhibitors and the cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) fusion protein abatacept are also associated with attenuated antibody responses, which are further diminished in patients taking concomitant immunosuppressants. On the other hand, integrin, IL-6, IL-12/23, IL-17, and B-cell activating factor (BAFF) inhibitors do not appear to affect the immune response to several vaccines evaluated. Importantly, treatment with biologic therapies in IMID patients is not associated with an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or developing severe disease. However, the efficacy of SARS-CoV-2 vaccines on IMID patients may be reduced compared with healthy individuals. The impact of biologic therapies on the response to SARS-CoV-2 vaccines seems to replicate what has been described for other vaccines. SARS-CoV-2 vaccination appears to be safe and well tolerated in IMID patients. Attenuated but, in general, still protective responses to SARS-CoV-2 vaccination in the context of certain therapies warrant current recommendations for a third primary dose in IMID patients treated with immunosuppressive drugs.
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Affiliation(s)
| | - Miguel Salavert
- Infectious Disease Unit, Department of Clinical Medicine, La Fe Health Research Institute, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
| | - José R. Regueiro
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, 12 de Octubre Health Research Institute (imas12), 28040 Madrid, Spain;
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18
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Dimethyl Fumarate's Effectiveness and Safety in Psoriasis: A Real-Life Experience During the COVID-19 Pandemic. Dermatol Ther (Heidelb) 2022; 12:671-681. [PMID: 35103934 PMCID: PMC8805130 DOI: 10.1007/s13555-022-00684-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/17/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Dimethyl fumarate (DMF) is approved as oral systemic treatment for moderate-to-severe psoriasis. Scarce evidence is available for DMF treatment in psoriatic patients at the time of COVID-19 pandemic. The objective of this study was to assess the long-term effectiveness and safety of DMF monotherapy in moderate-to-severe psoriasis during the COVID-19 pandemic period. Methods This multicenter, retrospective study included patients with moderate-to-severe psoriasis who had received a 48-week DMF treatment during the COVID-19 pandemic. Selected outcomes were: variation of mean PASI, proportion of patients achieving PASI50 and PASI75, variation of mean PGA and face PGA, genital PGA, scalp PGA, mean itch VAS and mean DLQI. Results Forty-four patients were enrolled, and four patients became COVID-19 positive during the observation period but did not discontinue DMF therapy. DMF produced a significant improvement of signs and symptoms of psoriasis as expressed by mean PASI variation from 13.07 at baseline to 6.11 at week 48 (p < 0.0001), itch VAS from 3.22 at baseline to 1.18 at week 48 (p < 0.001), PGA from 2.84 at baseline to 1.30 at week 48 (p < 0.0001) and DLQI from 13.09 at baseline to 6.07 at week 48 (p < 0.0001). The percentage of patients who achieved PASI50 and PASI75 was 4.55% at week 4 and 59.09% at week 48 and 0% at week 4 and 22.73% at week 48, respectively. A clinical important decrease of mean PGA score was observed in all subgroups, face psoriasis, genital psoriasis and scalp psoriasis. Adverse events were predictable and manageable. Conclusions DMF monotherapy is an effective and safe treatment option in moderate-to-severe psoriasis also in patients who develop SARS-CoV-2 infection.
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19
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Gisondi P, Bellinato F, Girolomoni G. Skin adverse reactions to Sars-CoV-2 vaccination: a relevant responsibility issue for dermatologists. J Eur Acad Dermatol Venereol 2022; 36:165-166. [PMID: 35037307 DOI: 10.1111/jdv.17854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - F Bellinato
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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20
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Musumeci ML, Caruso G, Trecarichi AC, Micali G. Safety of SARS-CoV-2 vaccines in psoriatic patients treated with biologics: A real life experience. Dermatol Ther 2021; 35:e15177. [PMID: 34699117 PMCID: PMC8646328 DOI: 10.1111/dth.15177] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 11/28/2022]
Abstract
Vaccination is the most effective method to prevent and control the SARS‐CoV‐2 infection and biologics are not considered a contraindication for vaccination. The burning question is that safety data are lacking since patients taking drugs affecting the immune system were excluded from clinical trials leading to vaccine approbation. Moreover, it seems that vaccination could worsen psoriasis. We conducted a survey to investigate the safety of SARS‐CoV‐2 vaccines in psoriatic patients treated with biologics. A total of 150 patients with stable plaque psoriasis treated with biologics for at least 2 months were evaluated in a 3 months period. Fifty patients (22 F/28 M; age: 33–83 years) only underwent the first and second doses of SARS‐CoV‐2 vaccines. All patients discontinued their biological agents 10 days before and 10 days after each dose of vaccine. Of these, 24 patients were treated with anti‐TNF, 14 with anti‐IL17, 7 with anti‐IL12‐23, and 5 with anti‐IL23. After the vaccines, all patients were evaluated at day 2, 7, and 14 for local and/or systemic side effects and/or adverse drug reactions to SARS‐CoV‐2 vaccines. None of the patients experienced any side effects or a psoriatic flare. Only one patient treated with infliximab biosimilar referred an exacerbation of psoriasis after vaccine. The remaining 100 patients reported that they did not get the vaccine yet. Our preliminary data confirm that SARS‐CoV‐2 mRNA vaccines are safe for patients with chronic plaque psoriasis treated with biologics and did not trigger psoriasis, although these data should be validated in a larger population. We encourage an early SARS‐CoV‐2 vaccines administration in all psoriatic patients on immunosuppressant drugs.
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21
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Simonetti O, Radi G, Molinelli E, Rizzetto G, Diotallevi F, Offidani A. Recommendations for dermatologists treating patients with atopic dermatitis during the Covid-19 pandemic: a look into the past for a conscious vaccination management. Hum Vaccin Immunother 2021; 17:3268-3275. [PMID: 34170791 DOI: 10.1080/21645515.2021.1925502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects approximately 20% of children and 10% of adults. The implication of vaccines as a trigger for the de novo onset of AD in children or as a cause of exacerbation in individuals with a history of AD has long been debated. We present a brief review of the literature on AD and traditional vaccinations, proposing in addition the main recommendations for the management of patients with AD undergoing the vaccine against the SARS-COV-2 virus. Live attenuated vaccines seem to be associated with a relapse of AD and/or complications, such as eczema vaccinatum. For non-live vaccines, no adverse events are noted in atopic subjects. Since the Covid-19 vaccine is mRNA or viral vectored vaccine and there are no other currently used vaccines of this type, the same recommendations are applied as for all other non-live vaccines.
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Affiliation(s)
- Oriana Simonetti
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Giulia Radi
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Elisa Molinelli
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Federico Diotallevi
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
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22
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Wang C, Rademaker M, Tate B, Baker C, Foley P. SARS-CoV-2 (COVID-19) vaccination in dermatology patients on immunomodulatory and biologic agents: Recommendations from the Australasian Medical Dermatology Group. Australas J Dermatol 2021; 62:151-156. [PMID: 33786833 PMCID: PMC8250550 DOI: 10.1111/ajd.13593] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/21/2021] [Indexed: 12/18/2022]
Abstract
As the phase III COVID-19 vaccine trials excluded patients on immunosuppressive treatments, or patients with significant autoimmunity, the Australasian Medical Dermatology Group make the following preliminary recommendations around COVID-19 vaccination in dermatology patients on immunomodulatory and/or biologic agents. Vaccination against COVID-19 is strongly encouraged for all patients on immunomodulatory drugs and/or biologic agents. There are currently insufficient data to recommend one COVID-19 vaccine or vaccine type (mRNA, recombinant, inactivated virus) over another. No specific additional risk in patients on immunomodulatory or biologic therapies has so far been identified. Data on vaccine efficacy in patients on immunomodulatory or biologic therapies are missing, so standard vaccination protocols are recommended until otherwise advised.
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Affiliation(s)
| | - Marius Rademaker
- Waikato Clinical CampusFaculty of Medical and Health Sciences, University of AucklandHamiltonNew Zealand
| | - Bruce Tate
- Western HospitalMelbourneVictoriaAustralia
| | - Christopher Baker
- Skin Health InstituteCarltonVictoriaAustralia
- St Vincent’s Hospital MelbourneThe University of MelbourneFitzroyVictoriaAustralia
| | - Peter Foley
- Skin Health InstituteCarltonVictoriaAustralia
- St Vincent’s Hospital MelbourneThe University of MelbourneFitzroyVictoriaAustralia
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23
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Fougerousse AC, Mery-Bossard L, Parier J, Taieb C, Bertolotti A, Maccari F. Use of Methotrexate in the Treatment of Moderate to Severe Plaque Psoriasis in France: A Practice Survey. Clin Cosmet Investig Dermatol 2021; 14:389-393. [PMID: 33935509 PMCID: PMC8079246 DOI: 10.2147/ccid.s311269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/15/2021] [Indexed: 01/25/2023]
Abstract
Purpose To evaluate the modalities of methotrexate prescription for moderate to severe psoriasis by dermatologists in France. Patients and Methods We performed a national online practice survey between October and December 2020. Results A total of 254 dermatologists responded, 237 reported prescribing methotrexate for moderate to severe psoriasis in adults, of which 57% as a first line systemic treatment. Nineteen percent reported performing a test dose at the initiation of treatment. Methotrexate was prescribed orally in 54.7% of cases, subcutaneously in 44.8% of cases and intramuscularly in 0.4% of cases. The initial weekly dose of methotrexate was <15 mg for 30% of the dermatologists and ≥15 mg for 70% of them. Two hundred and three dermatologists had already change the route of administration for methotrexate from the oral to injectable form due to poor tolerance (48.3%), lack of efficacy (35%) or lack of compliance (16.7%). Two hundred thirty-four dermatologists (98.7%) reported prescribing folic acid with methotrexate, and 79.3% reported prescribing tests evaluating the risk of hepatic fibrosis. Forty-three percent of dermatologists have not initiated or have reduced their prescriptions since the beginning of the pandemic of COVID-19. Prescribing patterns were different according to the type of practice (private practice versus hospital/mixed practice). Conclusion Methotrexate is used by the majority of dermatologists interviewed for moderate to severe psoriasis in adults, with heterogeneity of practices.
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Affiliation(s)
| | - Laure Mery-Bossard
- Dermatology Department, Centre Hospitalier Intercommunal Poissy Sant Germain en Laye, Saint-Germain-en-Laye, 78100, France
| | - Josiane Parier
- Private Practice, La Varenne Saint Hilaire, Saint-Maur-des-Fossés, 94210, France
| | - Charles Taieb
- European Market Maintenance Assessment, Patients Priority Department, Fontenay sous-Bois, France
| | - Antoine Bertolotti
- Infectious Diseases and Dermatology Department, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, La Réunion, France.,Inserm CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, La Réunion, France
| | - Francois Maccari
- Private Practice, La Varenne Saint Hilaire, Saint-Maur-des-Fossés, 94210, France
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24
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Gisondi P, Geat D, Naldi L, Piaserico S. Insights into Sars-CoV-2 vaccination in patients with chronic plaque psoriasis on systemic treatments. J Eur Acad Dermatol Venereol 2021; 35:e361-e362. [PMID: 33650226 PMCID: PMC8014730 DOI: 10.1111/jdv.17200] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/05/2021] [Accepted: 02/18/2021] [Indexed: 02/06/2023]
Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - D Geat
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - L Naldi
- Division of Dermatology, San Bortolo Hospital, Vicenza, Italy.,Centro Studi GISED, Bergamo, Italy
| | - S Piaserico
- Department of Medicine, Section of Dermatology, University of Padua, Padua, Italy
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25
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Kralj M, Jakovac H. Vitamin D and COVID-19 in an immunocompromised patient with multiple comorbidities-A Case Report. Clin Case Rep 2021; 9:2269-2275. [PMID: 33821193 PMCID: PMC8014728 DOI: 10.1002/ccr3.4010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
Routine 25‐OH‐Vitamin D3 measurement in COVID‐19 patients could be of great importance, either for clinical course estimation or deciding on supplementation.
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Affiliation(s)
- Martina Kralj
- Dermatology Department Karlovac General Hospital Karlovac Croatia
| | - Hrvoje Jakovac
- Department of Physiology and Immunology Medical Faculty University of Rijeka Rijeka Croatia
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26
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Richi P, Yuste J, Navío T, González-Hombrado L, Salido M, Thuissard-Vasallo I, Jiménez-Díaz A, Llorente J, Cebrián L, Lojo L, Steiner M, Cobo T, Martín MD, García-Castro M, Castro P, Muñoz-Fernández S. Impact of Biological Therapies on the Immune Response after Pneumococcal Vaccination in Patients with Autoimmune Inflammatory Diseases. Vaccines (Basel) 2021; 9:vaccines9030203. [PMID: 33671007 PMCID: PMC7997274 DOI: 10.3390/vaccines9030203] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Patients with different autoimmune inflammatory diseases (AIID) on biological therapy are at risk of pneumococcal disease. Adults with inflammatory arthropathies, connective tissue diseases, psoriasis, or inflammatory bowel disease on biological therapy such as anti-TNFα, rituximab, tocilizumab, abatacept, or anakinra were included in this study. Patients completed a protocol combining the pneumococcal vaccines PCV13 and PPV23. Immune response against pneumococcal serotypes 1, 3, 7F, 14, 19A, and 19F were assessed evaluating functional antibodies by an opsonophagocytosis killing assay (OPKA). In this study, 182 patients with AIID completed the sequential vaccination protocol. Patients on etanercept tended to achieve OPKA titers against a larger number of serotypes than the rest of patients on other biological therapies, while adalimumab was associated to a lower number of serotypes with OPKA titers. Rituximab was not associated with a worse response when compared with the rest of biological agents. Not glucocorticoids, nor synthetic disease-modifying antirheumatic drugs, interfered with the immune response. OPKA titers against serotype 3 which is one of the most prevalent, was obtained in 44% of patients, increasing up to 58% in those on etanercept. Hence, almost 50% of patients on biological therapy achieved functional antibodies after the administration of a complete pneumococcal vaccination protocol.
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Affiliation(s)
- Patricia Richi
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
- Correspondence: (P.R.); (J.Y.)
| | - Jose Yuste
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (P.R.); (J.Y.)
| | - Teresa Navío
- Rheumatology Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (T.N.); (L.C.); (L.L.)
| | | | - Marina Salido
- Rheumatology Unit, Hospital Universitario Infanta Cristina, Parla, 28981 Madrid, Spain; (M.S.); (P.C.)
| | | | - Ana Jiménez-Díaz
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
| | - Jesús Llorente
- Pharmacy Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, 28702 Madrid, Spain;
| | - Laura Cebrián
- Rheumatology Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (T.N.); (L.C.); (L.L.)
| | - Leticia Lojo
- Rheumatology Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (T.N.); (L.C.); (L.L.)
| | - Martina Steiner
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
| | - Tatiana Cobo
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
| | - María Dolores Martín
- BR Salud Laboratories, Bacteriology Department, San Sebastián de los Reyes, 28702 Madrid, Spain;
| | - Marta García-Castro
- Rheumatology Unit, Hospital del Tajo, Aranjuez, 28300 Madrid, Spain; (L.G.-H.); (M.G.-C.)
| | - Patricia Castro
- Rheumatology Unit, Hospital Universitario Infanta Cristina, Parla, 28981 Madrid, Spain; (M.S.); (P.C.)
| | - Santiago Muñoz-Fernández
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
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27
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Rick J, Thompson AM, Hsiao JL, Liao W, Shi VY. Immunosuppressants, immunomodulators and COVID-19 vaccines: anticipating patient concerns. J DERMATOL TREAT 2021; 33:1794-1797. [PMID: 33494626 DOI: 10.1080/09546634.2021.1880543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Jonathan Rick
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Jennifer L Hsiao
- Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, CA, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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28
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Who Is Really at Risk for Anaphylaxis Due to COVID-19 Vaccine? Vaccines (Basel) 2021; 9:vaccines9010038. [PMID: 33440794 PMCID: PMC7827676 DOI: 10.3390/vaccines9010038] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/19/2022] Open
Abstract
The vaccination campaign against the Severe acute respiratory syndrome coronavirus 2 (Sars-Cov-2) started on 8 December 2020 in UK, after the approval of BNT162b2 by the Healthcare products Regulatory Agency (MHRA) [...].
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