Skip to main content

Table 3 Recommendations for use of biologic therapy in psoriasis (after Nogueira et al. [78])

From: COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

Management Issue

Recommendation

Risk of severe COVID-19

Modest increased risk of URTI with TNF-alpha, IL-12/23, IL-23 and IL-17 blockers

Immunomodulatory drugs used for treatment of COVID-19 infection

Evaluate risk-to-benefit ratio for each patient

Do not blanket suspend biologic agents in all patients with psoriasis

Risk of flare-up of psoriasis

Flare-ups may necessitate visit to clinic or hospital with risk of COVID-19 transmission

Suspend biologic agent only for proven COVID-19 patients until fully recovered

Consider screening for SARS-COV-2 in patients commencing biologic therapy

Risk of drug resistance

Suspension and reintroduction of biologics may generate antibodies that affect response to drug, especially for TNF-alpha inhibitors

  1. URTI Upper respiratory tract infection, TNF Tumour necrosis factor, IL Interleukin