Safety analysis of biologics and highlighting vaccine hesitancy: real-world data shines a light on the impact of COVID-19 on psoriasis patients

Real-world data looking at biologic treatment and vaccine hesitancy in psoriasis patients is being presented at EADV’s 30th Congress.

The findings of two studies are helping to advance understanding of the safety of biological therapies for psoriasis and reasons for COVID-19 vaccine hesitancy in psoriasis patients. Researchers in Spain have studied sentiment towards COVID-19 vaccination in biologic-treated patients with psoriasis and/or psoriatic arthritis. The real-world data was collected via social media to minimise the limitations of traditional hospital surveys, which only capture data from motivated patients that could be impacted by the presence of a doctor.10,922 social media posts were identified between January and March 2021 from patients in the USA, UK, France, Germany and Spain using pre-defined keywords, which were then filtered down to 624 posts to be manually analysed to derive insights.

Important findings suggest that COVID-19 vaccine hesitancy in patients was driven by safety concerns and concerns about aggravation of their underlying condition (n=344). Main factors driving this perception were potential side effects post-vaccination, effect on their autoimmune conditions and lack of trial data. Moreover, patients had no information on the interaction of the COVID-19 vaccine with biologic therapy and did not know what effect it had in immuno-compromised patients.

Álvaro González-Cantero of the Department of Dermatology Hospital Universitario Ramon Y Cajal, Madrid, Spain said: “Looking forward, we know that we have to take these findings on board and educate patients on the importance, safety and effectiveness of the COVID-19 vaccine. We’re hoping to be able to collaborate with an Academy like the EADV to help us tackle vaccine hesitancy through education.”

Biologic treatments for psoriasis – a chronic inflammatory skin disease – are often associated with increased risk of infection. In a second real-word study , researchers in The Netherlands examined the differential effect of biological therapies on risk of respiratory tract infections (RTI) and serious infections (SI), including COVID-19, to help determine if any associations exist. A daily practice cohort of 714 psoriasis patients with 1325 treatment episodes from the BioCAPTURE registry was analysed, with 2224 RTI and 63 SI reported but only 1.3% of RTI reported as serious. Analysis found no differential risk of RTI between included biologics adalimumab, etanercept, infliximab, ustekinumab, secukinumab, ixekizumab, and guselkumab, and no association was revealed for serious infections. Regarding SARS-CoV-2 infections, the crude incidence rate was 3.8 (95% CI: 2.2-6.1) per 100 PY during 2020, in a single BioCAPTURE centre.

“Our analysis reveals no differences in risk of respiratory tract infections between biologics, including the newer IL-17 and IL-23 inhibitors, in a prospective psoriasis patients’ cohort. In addition, our preliminary results suggest that biological treatments do not impact psoriasis patients’ susceptibility to COVID-19 infections, although this needs to be further investigated,” says Lara van der Schoot of the Department of Dermatology at Radboud University Medical Center, Nijmegen, The Netherlands, and Lead Author of the study. “These findings provide key clinical value and will help to guide patient decisions with regard to psoriasis treatment options and choice.”