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Should psoriasis patients continue biologics during the COVID-19 pandemic? Plus CMS implements changes to aid the COVID-19 response

Thursday, April 2, 2020

Patients with severe psoriasis may be at higher risk for infection because of increased inflammation in the body. Dr. Lawrence Green discusses how to counsel patients who are taking biologics to control their psoriasis during the COVID-19 pandemic. “What I recommend [is to] stay on your biologic as long as you can unless you have exposure [or] you start to feel feverish,” Dr. Green advises.

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We also bring you the latest in dermatology news and research:

1. CMS implements temporary regulatory changes to aid COVID-19 response

2. FDA issues EUA allowing hydroxychloroquine sulfate, chloroquine phosphate treatment in COVID-19

3. FDA okays emergency use of convalescent plasma for seriously ill COVID-19 patients

4. Physician couples draft wills, face tough questions amid COVID-19

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Key takeaways from this episode:

  • Patients with uncontrolled psoriasis symptoms are at higher risk for developing infection and other comorbidities. “In general, I have told patients that if they stop the biologic for some time and the psoriasis comes back so that it’s severe again, I think that it’s significantly more risky for getting COVID-19 than if they continue to take their biologic,” says Dr. Green.
  • There currently are no data on whether biologics help or harm patients with COVID-19.
  • Anti–tumor necrosis factor (anti-TNF) agents may be useful in helping control pneumonia, but they also are associated with an increased risk for infection, compared with other biologic agents. It may be safer for patients to switch to or continue treatment with anti–IL-17 or anti–IL-23 agents during the COVID-19 pandemic.
  • Patients should stop biologic treatment if they have exposure to someone with COVID-19 or start to show symptoms. “Stopping a biologic for a few weeks will not bring your psoriasis back. ... [but] a few months off can make a difference,” Dr. Green explains.
  • Patients currently on biologics should take extra precautions to practice social distancing, stay at home when possible, wash hands, use hand sanitizer, and avoid touching the face, as recommended by the Centers for Disease Control and Prevention.
  • For additional resources, dermatologists can consult the American Academy of Dermatology or the National Psoriasis Foundation guidelines on psoriasis treatment during the COVID-19 pandemic.

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Host: Nick Andrews

Guest: Lawrence J. Green, MD (George Washington University, Washington)

Show notes by: Alicia Sonners, Melissa Sears

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Interact with us on Twitter: @MDedgeDerm

Podcast Participants

Vincent A. DeLeo, MD
Vincent A. DeLeo, MD, is from the Keck School of Medicine of the University of Southern California, Los Angeles, and the Icahn School of Medicine at Mount Sinai, New York, New York. He also is the editor in chief of Cutis and the author of more than 200 publications. He is a leading expert on contact dermatitis, sunscreens, and photosensitivity. Dr. DeLeo is a consultant for Estée Lauder.