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Biologics for Psoriasis in the COVID-19 Era

Dr. Jashin J. Wu discusses psoriasis research that examines the association between systemic treatments and COVID-19 infection risk.

Jashin J. Wu, MD, FAAD, is Founder and CEO, Dermatology Research and Education Foundation; and Founder and Course Director of Skin Cancer Symposium + Symposium for Inflammatory Skin Disease, San Diego Dermatology Symposium, and Dermatology Refresher Symposium.

Are patients with psoriasis at a higher risk of contracting COVID-19? Can you treat this population with systemic therapies safely during the pandemic? Those are the questions Jashin J. Wu, MD, FAAD, and colleagues addressed in research presented at this year’s inaugural Symposium for Inflammatory Skin Disease, a planned annual virtual meeting. 

Dr. Wu, Course Director of the symposium, sat down with The Dermatology Digest to discuss the poster, “Association Between Systemic Treatments and COVID-19 Infection Risk in Patients with Psoriasis.”

First, Dr. Wu et al. gathered data on COVID-19 incidence in patients with psoriasis.

“We had this large data set—we had over 167,000 patients with psoriasis—and we checked to see the incidence of COVID-19 infection in these patients compared to the general population,” said Dr. Wu. 

They found an 18% higher incident of COVID-19 among patients with psoriasis. 

Second, they looked at risk in patients with psoriasis in terms of treatment with systemic vs topical therapies. Subset analyses revealed those patients on systemic therapies had a lower incidence of COVID-19 infection:

  • TNF-⍺ inhibitors by 13%
  • Interleukin-23 inhibitors by 26%
  • Methotrexate by 19%
  • Apremilast by 30%

According to Dr. Wu, the therapies with broader inflammatory cytokine effects may offer better protection from COVID-19 infection, whereas those that are more targeted and potentially efficacious for the treatment of psoriasis may not be as effective at lowering COVID-19 risk.

“Just because there’s a pandemic going on, it doesn’t mean you cannot have a patient on a systemic agent,” said Dr. Wu. “So some of these agents may actually potentially prevent [patients] from getting COVID-19 infection. If they really need to have a systemic agent, you just need to be aware that some may increase the risk; some may decrease the risk.”