Brownstone Nicholas D, Thibodeaux Quinn G, Reddy Vidhatha D, Myers Bridget A, Chan Stephanie Y, Bhutani Tina, Liao Wilson
Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, CA USA.
Dermatol Ther (Heidelb). 2020 Apr 16;10(3):339-349. doi: 10.1007/s13555-020-00377-9. eCollection 2020 Jun.
With the emergence of the novel coronavirus disease (COVID-19) viral pandemic, there is uncertainty whether biologic agents for psoriasis may place patients at a higher risk for infection or more severe disease course. This commentary offers patient counseling recommendations based on the current available evidence. While there are currently no specific data for psoriasis biologics and COVID-19, data are presented here from phase III clinical trials of psoriasis biologics on rates of upper respiratory infection, influenza, and serious infection. Overall these data reveal that on the whole, psoriasis biologics do not show major increases in infection risk compared to placebo during the course of these trials. However, as the COVID-19 virus is a novel pathogen that is associated with mortality in a subset of patients, a cautious approach is warranted. We discuss factors that may alter the benefit-risk ratio of biologic use during this time of COVID-19 outbreak. Ultimately, treatment decisions should be made on the basis of dialogue between patient and provider, considering each patient's individualized situation. Once this pandemic has passed, it is only a matter of time before a new viral disease reignites the same issues discussed here.
随着新型冠状病毒病（COVID-19）大流行的出现，用于治疗银屑病的生物制剂是否会使患者面临更高的感染风险或更严重的病程尚不确定。本评论基于当前可得证据提供患者咨询建议。虽然目前尚无关于银屑病生物制剂与COVID-19的具体数据，但此处呈现了银屑病生物制剂III期临床试验中关于上呼吸道感染、流感和严重感染发生率的数据。总体而言，这些数据表明，在这些试验过程中，与安慰剂相比，银屑病生物制剂总体上并未显示出感染风险大幅增加。然而，由于COVID-19病毒是一种新型病原体，在部分患者中与死亡率相关，因此有必要采取谨慎的方法。我们讨论了在COVID-19疫情期间可能改变生物制剂使用效益风险比的因素。最终，治疗决策应基于患者与医疗服务提供者之间的对话，考虑每位患者的个体情况。一旦这场大流行过去，新的病毒性疾病引发此处讨论的相同问题只是时间问题。
