- Smith C. The impact of the COVID-19 pandemic on people with psoriasis: an update from the PsoProtect and PsoProtectMe global registries FC-16, Psoriasis from Gene to Clinic 2021, 9–11 December.
PsoProtect collects data from clinicians on their psoriasis patients with confirmed or suspected COVID-19 on a global online platform. Prof. Catherine Smith (King's College London, UK) reported the latest findings from a data-cut in July 2021 that included 1,272 cases. The cohort consisted of 40% women, had a mean age of 49 years, and 86% were White. Systemic treatment was given to 87% of the patients, with 70% receiving biologics.
“We found that, as in our earlier analysis, risk factors associated with hospitalisation in people with psoriasis are the same as in the general population: male sex, age, non-white ethnicity, and comorbidities,” Prof. Smith stated. Concerning comorbidities, significantly increased likelihoods of hospitalisation were seen for hypertension (odds ratio (OR) 1.81; 95% CI 1.18¬–2.78), chronic liver disease (OR 2.48; 95% CI 1.37–4.48), and chronic lung disease (OR 2.5; 95% CI 1.41–4.43).
Also, patients on non-biologic immunosuppression, mostly with methotrexate, acitretin, or apremilast, were more prone to hospitalisation than those on biologics (OR 2.37; 95% CI 1.5–3.76). To achieve the necessary amount of statistical power to differentiate between treatment regimens, PsoProtect sought collaboration with registries of other immune‐mediated inflammatory diseases. This led to pooled data of over 6,000 patients with psoriasis, rheumatologic diagnoses, and inflammatory bowel disease. The analysis that assessed the risk of hospitalisation for COVID-19 or death suggested that anti-TNF monotherapy was protective compared with standard systemic immunotherapy.
Prof. Smith stressed that it was reassuring that findings seemed to be consistent across all 3 registries. The pooled analysis of risk for hospitalisation or death in patients with suspected and confirmed COVID-19 led to an OR of 2.0 (95% CI 1.57–2.56) for methotrexate monotherapy versus TNF-inhibitor monotherapy. The sensitivity analysis, comprising only confirmed cases, resulted in an OR of 2.1 (95% CI 1.62–2.72) for the same comparison. “But these findings need to be interpreted with caution: first, this is an association and not causation, but also the reporting of patients through these registries is subject to bias and findings really do need to be validated in population-based data sets,” Prof. Smith pointed out.