National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2-Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments

Joel M Gelfand¹, April W Armstrong², Stacie Bell³, George L Anesi⁴, Andrew Blauvelt⁵, Cassandra Calabrese⁶, Erica D Dommasch⁷, Steven R Feldman⁸, Dafna Gladman⁹, Leon Kircik¹⁰, Mark Lebwohl¹¹, Vincent Lo Re 3rd¹², George Martin¹³, Joseph F Merola¹⁴, Jose U Scher¹⁵, Sergio Schwartzman¹⁶, James R Treat¹⁷, Abby S Van Voorhees¹⁸, Christoph T Ellebrecht¹⁹, Justine Fenner¹¹, Anthony Ocon²⁰, Maha N Syed¹⁹, Erica J Weinstein²¹, George Gondo³, Sue Heydon³, Samantha Koons³, Christopher T Ritchlin²⁰

Affiliations

¹ Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Joel.Gelfand@pennmedicine.upenn.edu.
² Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
³ National Psoriasis Foundation, Portland, Oregon.
⁴ Department of Biostatistics, Epidemiology and Informatics and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
⁵ Oregon Medical Research Center, Portland, Oregon.
⁶ Department of Rheumatology and Immunology, Cleveland Clinic, Cleveland, Ohio.
⁷ Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
⁸ Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
⁹ Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; University of Toronto, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.
¹⁰ Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Indiana University Medical Center, Indianapolis, Indiana.
¹¹ Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
¹² Department of Biostatistics, Epidemiology and Informatics and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
¹³ Dermatology Associates, Maui, Hawaii.
¹⁴ Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
¹⁵ Department of Medicine, Division of Rheumatology, New York University Grossman School of Medicine and New York University Langone Orthopedic Hospital, New York, New York.
¹⁶ Department of Rheumatology, Hospital for Special Surgery, New York, New York.
¹⁷ Department of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
¹⁸ Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia.
¹⁹ Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
²⁰ Division of Allergy, Immunology, and Rheumatology Division, University of Rochester Medical Center, Rochester, New York.
²¹ Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

PMID: 33422626
PMCID: PMC7788316
DOI: 10.1016/j.jaad.2020.12.058

Practice Guideline

National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2-Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments

Joel M Gelfand et al. J Am Acad Dermatol. 2021 May.

. 2021 May;84(5):1254-1268.

doi: 10.1016/j.jaad.2020.12.058. Epub 2021 Jan 7.

Authors

Affiliations

¹ Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Joel.Gelfand@pennmedicine.upenn.edu.
² Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
³ National Psoriasis Foundation, Portland, Oregon.
⁴ Department of Biostatistics, Epidemiology and Informatics and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
⁵ Oregon Medical Research Center, Portland, Oregon.
⁶ Department of Rheumatology and Immunology, Cleveland Clinic, Cleveland, Ohio.
⁷ Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
⁸ Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
⁹ Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada; University of Toronto, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.
¹⁰ Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Indiana University Medical Center, Indianapolis, Indiana.
¹¹ Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
¹² Department of Biostatistics, Epidemiology and Informatics and Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
¹³ Dermatology Associates, Maui, Hawaii.
¹⁴ Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
¹⁵ Department of Medicine, Division of Rheumatology, New York University Grossman School of Medicine and New York University Langone Orthopedic Hospital, New York, New York.
¹⁶ Department of Rheumatology, Hospital for Special Surgery, New York, New York.
¹⁷ Department of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
¹⁸ Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia.
¹⁹ Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
²⁰ Division of Allergy, Immunology, and Rheumatology Division, University of Rochester Medical Center, Rochester, New York.
²¹ Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

PMID: 33422626
PMCID: PMC7788316
DOI: 10.1016/j.jaad.2020.12.058

Abstract

Objective: To update guidance regarding the management of psoriatic disease during the COVID-19 pandemic.

Study design: The task force (TF) includes 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care. The TF was supplemented by nonvoting members, which included fellows and National Psoriasis Foundation staff. Clinical questions relevant to the psoriatic disease community were informed by inquiries received by the National Psoriasis Foundation. A Delphi process was conducted.

Results: The TF updated evidence for the original 22 statements and added 5 new recommendations. The average of the votes was within the category of agreement for all statements, 13 with high consensus and 14 with moderate consensus.

Limitations: The evidence behind many guidance statements is variable in quality and/or quantity.

Conclusions: These statements provide guidance for the treatment of patients with psoriatic disease on topics including how the disease and its treatments affect COVID-19 risk, how medical care can be optimized during the pandemic, what patients should do to lower their risk of getting infected with severe acute respiratory syndrome coronavirus 2 (including novel vaccination), and what they should do if they develop COVID-19. The guidance is a living document that is continuously updated by the TF as data emerge.

Keywords: COVID-19; SARS-CoV-2; biologics; psoriasis; psoriatic arthritis; vaccines.

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Conflict of interest statement

Conflicts of interest Dr Gelfand has served as a consultant for Bristol Myers Squibb, Boehringer Ingelheim, GlaxoSmithKline, Janssen Biologics, Novartis Corp, Regeneron, UCB (Data Safety and Monitoring Board), Sanofi, and Pfizer, receiving honoraria; has received research grants (to the Trustees of the University of Pennsylvania) from AbbVie, Janssen, Novartis Corp, Sanofi, Celgene, OrthoDermatologics, and Pfizer; has received payment for continuing medical education work related to psoriasis that was supported indirectly by Eli Lilly and Company and Ortho Dermatologics; is a copatent holder of resiquimod for treatment of cutaneous T-cell lymphoma; and is a deputy editor for the Journal of Investigative Dermatology, receiving honoraria from the Society for Investigative Dermatology. Dr Armstrong has served as a research investigator and/or scientific advisor to Leo, AbbVie, UCB, Incyte, Janssen, Lilly, Novartis, Ortho Dermatologics, Sun, Dermavant, Bristol Myers Squibb, Sanofi, Regeneron, Dermira, and Modmed. Dr Bell is an employee of the National Psoriasis Foundation. Dr Anesi is supported by the Agency for Healthcare Research and Quality (K12HS026372) and has received fees from UpToDate for authoring COVID-19 clinical reference material. Dr Blauvelt has served as a scientific advisor and/or clinical study investigator for AbbVie, Almirall, Arena, Athenex, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, Eli Lilly and Company, Evommune, Forte, Galderma, Incyte, Janssen, Leo, Novartis, Pfizer, Rapt, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB Pharma. Dr Calabrese is a speaker for Sanofi-Regeneron and consultant for AbbVie. Dr Feldman has received research, speaking, and/or consulting support from Galderma, GlaxoSmithKline/Stiefel, Almirall, Alvotech, Leo Pharma, Bristol Myers Squibb, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Ortho Dermatology, AbbVie, Samsung, Janssen, Lilly, Menlo, Merck, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate, and National Psoriasis Foundation; has consulted for others through Guidepoint Global, Gerson Lehrman, and other consulting organizations; is the founder and majority owner of www.DrScore.com; and is a founder and part owner of Causa Research, a company dedicated to enhancing patients' adherence to treatment. Dr Gladman is a consultant for AbbVie, Amgen, Bristol Myers Squibb, Galapagos, Gilead, Eli Lilly, Janssen, Novartis, Pfizer, and UCB and has received grants from AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. Dr Kircik has served either as an investigator, consultant, or speaker for AbbVie, Almirall, Amgen, Arcutis, Bausch Health Canada, Bristol Myers Squibb, Boehringer Ingelheim, Cellceutix, Celgene, Coherus, Dermavant, Dermira, Eli Lilly, Leo, MC2, Maruho, Novartis, Ortho Dermatologics, Pfizer, Dr Reddy's Laboratories, Sun Pharma, UCB, Taro, and Xenoport. Dr Lebwohl is an employee of Mount Sinai; receives research funds from AbbVie, Amgen, Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Incyte, Janssen Research and Development, Leo Pharmaceuticals, Ortho Dermatologics, Pfizer, and UCB; and is a consultant for Aditum Bio, Allergan, Almirall, Arcutis, Avotres Therapeutics, BirchBioMed, BMD Skincare, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Kyowa Kirin, LEO Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, Neuroderm, Pfizer, Promius/Dr Reddy's Laboratories, Serono, Theravance, and Verrica. Dr Martin is a consultant for Almirall, Athenex, Bristol Meyers Squibb, Celgene, Eli Lilly, LEO, Ortho Dermatologic, Pfizer, and UCB and a scientific advisor for Almirall, Athenex, Bristol Meyers Squibb, Celgene, Eli Lilly, Janssen, LEO, Ortho Dermatologic, Pfizer, and UCB. Dr Merola is a consultant and/or investigator for Bristol Myers Squibb, AbbVie, Dermavant, Eli Lilly, Novartis, Janssen, UCB, Sun Pharma, Pfizer, and EMD Serono. Dr Scher is a consultant for UCB, Janssen, AbbVie, Pfizer, Novartis, Bristol Myers Squibb, and Sanofi and is supported in part by the Riley Family Foundation and the Beatrice Snyder Foundation. Dr Schwartzman is a speaker for AbbVie, Genentech, Janssen, Lilly, Novartis, Pfizer, and UCB; owns stock in Amgen, Boston Scientific, Gilead, Medtronic, and Pfizer; is a consultant for AbbVie, Myriad, Janssen, Gilead, Lilly, Novartis, and UCB; is a scientific advisory board member for Myriad; and is a board member of the National Psoriasis Foundation. Dr Van Voorhees has been an investigator for Celgene, Lilly, and AbbVie and an advisor/consultant for AbbVie, Allergan, AstraZeneca, Celgene, Dermira, Merck, Novartis, Pfizer, UCB, and Valeant. Dr Syed is supported by a grant from Pfizer. Authors Gondo, Heydon, and Koons are employees of the National Psoriasis Foundation. Dr Ritchlin reports personal fees from AbbVie, Amgen, Janssen, Novartis, UCB, and Boehringer Ingelheim, as well as grants from Amgen, UCB, and AbbVie outside the submitted work. Drs Dommasch, Lo Re, Treat, Ellebrecht, Fenner, Ocon, and Weinstein have no conflicts of interest to declare.

References

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1. Johns Hopkins Coronavirus Resource Center COVID-19 map. Accessed December 18, 2020. https://coronavirus.jhu.edu
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National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2-Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments

Affiliations

National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2-Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments

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