COVID-19 Latest: British Study Finds That Psoriasis Patients Taking Immunosuppressants Have High COVID-19 Survival Rates
: According to the research findings from a global registry of psoriasis and COVID-19 patients, led by Guy's and St Thomas' clinicians, patients with psoriasis who are taking drugs that affect their immune system have high rates of survival from COVID-19, in most cases almost over 90% survive.
The study findings were published in the Journal of Allergy and Clinical Immunology
The study team used clinician-reported registry data to investigate the demographic and disease-specific factors associated with the primary outcome of hospitalization for COVID-19. The key exposure measure was treatment type for psoriasis at or up to four weeks prior to COVID-19 onset, comprising: biologics (TNF inhibitors: adalimumab, certolizumab pegol, etanercept, infliximab, golimumab; IL-17 inhibitors: brodalumab, ixekizumab, secukinumab; IL12/IL 23p40 or IL-23p19 [collectively IL-23] inhibitors: guselkumab, risankizumab, tildrakizumab, ustekinumab), non-biologic systemic agents (acitretin, apremilast, ciclosporin, methotrexate, fumaric acid esters/dimethylfumarate, prednisolone), and no systemic treatment.
The study team found that the risk factors of severe COVID-19 outcomes in patients reported to the registry were similar to the general population.
The findings come from the first analysis of the web-based PsoProtect registry, established to understand how psoriasis and the medications that are used to treat it might influence the severity of COVID-19.
Strategic collaboration has been crucial to the registry, founded by dermatologists and researchers at the St John's Institute of Dermatology at Guy's and St Thomas', King's College London and University of Manchester, and supported by psoriasis patient organizations throughout the world, including the Psoriasis Association in the UK.
Typically psoriasis is a skin condition that causes red, flaky, crusty plaques of skin covered with silvery scales and affects around 2% of people in the UK. It is thought to be related to a problem in the immune system, so dermatologists have been working to understand how COVID-19 and the condition may interact.
Most of the time, patients with moderate to severe disease are treated with drugs that affect the immune system including biologics that target specific immune proteins, or traditional tablet immunosuppressants, and many of these patients were asked to shield during the pandemic.
A consultant dermatologist, Dr Satveer Mahil from the St John's Institute of Dermatology at Guy's and St Thomas', co-leads the registry.
Dr Mahil told Thailand Medical News, “Our analysis is important for informing our conversations with patients as the pandemic continues. We can reassure our patients that the survival for people with psoriasis is high, and the risk factors for psoriasis patients are similar to those of the general population.”
She added, “These findings wouldn't be possible without all the clinicians who have reported cases to PsoProtect and the invaluable support of our partner professional and patient organizations."
Dr Helen McAteer, Chief Executive of the Psoriasis Association commented, “From the beginning of the pandemic we understood the importance of being proactive in order to address the many concerns expressed by people who are living with psoriasis. The PsoProtect registry is vital in helping us understand more about the interactions between psoriasis, its treatments and COVID-19 infection so as patients can make the most informed choices about their care and treatment at this challenging time."
The study is an analysis of 374 clinician-reported cases where patients with psoriasis had COVID-19. The cases came from 25 countries and were submitted between March and July 2020. Most of the patients (334, 89%) were taking biologics for their psoriasis (267, 71%) or traditional immunosuppressants (67, 18%).
The study found that for most of the cases-348 (93%) fully recovered from COVID-19, 77 (21%) were hospitalized and nine (2%) died. The study found that, similarly to the general population, patients who were older, male, of non-white ethnicity and with other health conditions such as chronic lung disease were more likely to require hospital admission for their COVID-19 infection.
The so called ‘PsoProtect team’ is a group of academic clinicians and scientists at St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London; the Dermatology Centre, University of Manchester; and patient representatives from the Psoriasis Association (UK).
The team concluded, “In this international moderate-severe psoriasis case series, biologics use was associated with lower risk of COVID-19-related hospitalization than non-biologic systemic therapies, however further investigation is warranted due to potential selection bias and unmeasured confounding. Established risk factors (being older, male, non-white ethnicity, comorbidities) were associated with higher hospitalization rates.
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