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 |