Gisondi Paolo, Geat Davide, Bellinato Francesco, Girolomoni Giampiero
Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy.
Expert Opin Biol Ther. 2022 Dec;22(12):1521-1529. doi: 10.1080/14712598.2022.2110467. Epub 2022 Aug 8.
Given the increased infectious risk associated with biologics, particularly with TNFα inhibitors, concerns were raised over the safety of these agents in relation to SARS-CoV-2 infection. Furthermore, the impact of biologics on SARS-CoV-2 vaccination was questioned.
In this review, studies conducted on patients with moderate to severe plaque psoriasis treated with biologics during the COVID-19 pandemic have been analyzed, including 1) the safety of biologics in psoriatic patients in terms of increased risk and/or worse outcome of SARS-CoV-2 infection; and 2) whether biologic agents could affect the safety and response to SARS-CoV-2 vaccines in psoriatic patients.
Current evidence indicates that the use of biologics in psoriatic patients does not seem to be associated with an increased COVID-19 infection risk or worse outcome, with TNFα inhibitors being even protective of severe COVID-19 relative to other treatments or no treatment at all. Furthermore, biologic treatment does not seem to have a significant impact on the response and safety of vaccines in patients with psoriasis treated with biologics. However, uncertainty remains given the limitations of current studies which are often of short duration, limited sample sizes and do not stratify on specific biologic classes.
鉴于生物制剂，尤其是肿瘤坏死因子α（TNFα）抑制剂相关的感染风险增加，人们对这些药物在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染方面的安全性提出了担忧。此外，生物制剂对SARS-CoV-2疫苗接种的影响也受到质疑。
在本综述中，分析了在2019冠状病毒病（COVID-19）大流行期间对接受生物制剂治疗的中度至重度斑块状银屑病患者进行的研究，包括：1）就SARS-CoV-2感染风险增加和/或预后较差而言，生物制剂在银屑病患者中的安全性；以及2）生物制剂是否会影响银屑病患者对SARS-CoV-2疫苗的安全性和反应。
目前的证据表明，在银屑病患者中使用生物制剂似乎与COVID-19感染风险增加或预后较差无关，相对于其他治疗或不进行任何治疗，TNFα抑制剂甚至对严重COVID-19具有保护作用。此外，生物制剂治疗似乎对接受生物制剂治疗的银屑病患者的疫苗反应和安全性没有显著影响。然而，鉴于当前研究存在局限性，如研究时间往往较短、样本量有限且未按特定生物制剂类别进行分层，不确定性仍然存在。
