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

Background: Since March 2020, the coronavirus disease 2019 (COVID-19) pandemic has been ongoing all around the world with a wide range of clinical course including asymptomatic cases to severe and fatal respiratory tract disease. Patients on immunosuppressive treatments were predicted to be more susceptible to COVID-19.

Aims: It was aimed to assess treatment continuity, the course of psoriasis and the course and clinical features of COVID-19 in patients treated with biological agents for psoriasis at the early initial period of COVID-19 pandemic.

Patients/methods: Patients treated with biological agents for psoriasis at our institute were contacted by phone between 1 and 10 July 2020 and fulfilled a questionnaire about their continuity to psoriasis treatments, clinical course of psoriasis, and any suspicion/diagnosis of COVID-19.

Results: A total of 106 patients, 41 females and 65 males, were enrolled. Mean age of the patients was 46.1 ± 12.1 years (range: 19-77). Median duration of psoriasis was 18 years (min-max: 1 month-51 years). Twenty-four patients (22.6%) were using tumor necrosis alpha inhibitors (ETA:1, IFX:19, ADA:4), whereas 82 patients (77.4%) were using interleukin (IL) 12/23 or IL-17 inhibitors (UST:48, SECU:30, IXE:4). Seventy-six patients (71.7%) continued the treatment, whereas 30 patients (28.3%) interrupted the treatment voluntarily. Twenty out of 30 patients (66.6%) who interrupted the treatment had an exacerbation of psoriasis. None of the patients were diagnosed with COVID-19 in the study period.

Conclusion: Patients with psoriasis who received biological therapy continued their treatment at a high rate during the early period of the COVID-19 pandemic. No COVID-19 diagnosis was made among patients whether they continued or discontinued treatment. Recurrence and exacerbation of psoriasis in a significant proportion of patients who interrupted treatment and absence of COVID-19 diagnosis in each group support the importance and safety of continuity of biological treatments for psoriasis in COVID-19 era.