Challenges in managing immunosuppressive therapies for psoriasis during the COVID-19 pandemic

Abstract

Introduction: During the midst of the coronavirus disease 2019 (COVID-19) pandemic, dermatologists treating psoriasis are presented with the challenge of managing immunosuppressive and immunomodulatory therapies while ensuring patient safety. Objective: Here we discuss the systemic therapies for psoriasis and their implications in the context of COVID-19 pandemic, including the recommendations of leading dermatological societies and organizations. Discussion: Currently, there are no definitive data regarding the impact of specific immunosuppressive and immunomodulatory therapies used for psoriasis on the natural history of COVID-19. However, the concern is that many of these medications may increase the risk of infection or prolong the clearance of the virus, although there is some ongoing speculation that some immunomodulatory therapies may actually prevent detrimental complications of coronavirus infection. Conclusions: Due to the lack of evidence, we recommend that all patients on immunomodulatory and immunosuppressive therapies for psoriasis stop their treatment immediately if they are diagnosed with COVID-19 or are exposed to someone diagnosed with COVID-19. Meanwhile, until the current situation gets resolved, we recommend that the decision to continue or stop systemic treatments for psoriasis should be made on an individual basis, taking into account the patient’s current progress on the treatment and the patient’s concomitant risk factors for COVID-19 as outlined by the Centers for Disease Control and Prevention (CDC).

Keywords

• sars-cov2
• covid-19
• coronavirus
• immunosuppressive
• immunomodulatory
• psoriasis