Recently, it was suggested that a patient-centric, evidence-based discussion must entail before initiating biologic and other systemic immunomodulating medications. In fact, certain biologics––especially, antitumor necrosis factor therapies––are associated with an increased risk of upper respiratory illnesses, as well as increased infections with IL-17 and IL-23 blocking agents.Incidentally, patients on biologics do not have higher rates of COVID-19-related infections or severe outcomes.

A retrospective chart review of patientswas carried out on biologics in three practices spanning New York, New Jersey, and California, from January to August 2020. The study included 183 patients with psoriasis, hidradenitis suppurativa and atopic dermatitis. 

The findings hinted towards a probable role for biologic immunomodulatory therapies in the treatment of COVID-19 as they can downregulate some of the key cytokines involved in the cytokine release syndrome. In particular, early data indicate that there may be a role for biologic immunomodulatory therapies in the treatment of COVID-19 as they can downregulate some of the key cytokines involved in the cytokine release syndrome.

Current guidelines from the American Academy of Dermatology (AAD) and National Psoriasis Foundation (NPF) support continuation of immunomodulatory medications during this pandemic for patients who are not experiencing symptoms of COVID-19. 

Source: International Journal of Dermatology. September 2021. Doi: 10.1111/ijd.15922