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. 2023 Mar 16:14:1107438.
doi: 10.3389/fimmu.2023.1107438. eCollection 2023.

COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

Georg Christian Lodde  1 , Frederik Krefting  1 , Jan-Malte Placke  1 , Lea Schneider  1 , Melanie Fiedler  2 , Ulf Dittmer  2 , Jürgen Christian Becker  1   3   4 , Stefanie Hölsken  5 , Dirk Schadendorf  1   4 , Selma Ugurel  1   4 , Wiebke Sondermann  1
Affiliations

COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

Georg Christian Lodde et al. Front Immunol. .

Abstract

Background: The rate of seroconversion after COVID-19 vaccination in patients with moderate to severe psoriasis requiring systemic treatment is poorly understood.

Objectives: The aim of this prospective single-center cohort study performed between May 2020 and October 2021 was to determine the rate of seroconversion after COVID-19 vaccination in patients under active systemic treatment for moderate to severe psoriasis.

Methods: Inclusion criteria were systemic treatment for moderate to severe psoriasis, known COVID-19 vaccination status, and repetitive anti-SARS-CoV-2-S IgG serum quantification. The primary outcome was the rate of anti-SARS-CoV-2-S IgG seroconversion after complete COVID-19 vaccination.

Results: 77 patients with a median age of 55.9 years undergoing systemic treatment for moderate to severe psoriasis were included. The majority of patients received interleukin- (n=50, 64.9%) or tumor necrosis factor (TNF)-α inhibitors (n=16, 20.8%) as systemic treatment for psoriasis; nine patients (11.7%) were treated with methotrexate (MTX) monotherapy, and one patient each received dimethyl fumarate (1.3%), respectively apremilast (1.3%). All included patients completed COVID-19 vaccination with two doses over the course of the study. Serum testing revealed that 74 patients (96.1%) showed an anti-SARS-CoV-2-S IgG seroconversion. While all patients on IL-17A, -12 or -12/23 inhibitors (n=50) achieved seroconversion, three of 16 patients (18.8%) receiving MTX and/or a TNF-α inhibitor as main anti-psoriatic treatment did not. At follow-up, none of the patients had developed symptomatic COVID-19 or died from COVID-19.

Conclusions: Anti-SARS-CoV-2-S IgG seroconversion rates following COVID-19 vaccination in psoriasis patients under systemic treatment were high. An impaired serological response, however, was observed in patients receiving MTX and/or TNF-α inhibitors, in particular infliximab.

Keywords: COVID-19 vaccines; biologics; psoriasis; psoriasis treatment; seroconversion.

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Conflict of interest statement

GL has received travel support from Sun Pharma. FK has received travel support and/or personal fees from Novartis and Almirall. MF has given a paid lecture for Dia Sorin. UD reports consulting fees from Biontech and Moderna, and advisory board honoraria from Moderna outside the submitted work. J-MP served as consultant and/or has received honoraria from Bristol-Myers Squibb and Novartis, and received travel support from Bristol-Myers Squibb, Novartis, Pierre Fabre and Therakos. JB declares speaker honoraria from Amgen and Sanofi; advisory board honoraria from 4SC, Almirall, Amgen, MerckSerono, Novartis, InProTher, and Sanofi; research funding from Alcedis, Bristol-Myers Squibb, HTG, IQVIA, and MerckSerono; travel support from 4SC and Incyte. DS reports grants or contracts from Amgen, Array/Pfizer, Bristol-Myers Squibb, MSD, Novartis and Roche; consulting fees from 4SC, Amgen, Array Biopharma, AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo, Haystick, Immunocore, InFlarX, Innocent, LabCorp, Merck Serono, MSD, Nektar, NeraCare, Novartis, OncoSec, Pfizer, Philogen, Pierre Fabre, Replimune, Roche, Sandoz, Sanofi/Regeneron, Sun Pharma; honoraria from Bristol-Myers Squibb, MSD/Merck, Merck Serono, Novartis, Roche, Sanofi and Sun Pharma; support for attendings meetings or travel support from Bristol-Myers Squibb, MSD, Merck Serono, Novartis, Pierre Fabre and Sanofi; participation on drug safety monitoring or advisory boards for 4SC, Amgen, Array Biopharma, AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo, Immunocore, InFlarX, Merck Serono, MSD, Nektar, NeraCare, Novartis, OncoSec, Pfizer, Philogen, Pierre Fabre, Replimune, Roche, Sandoz, Sanofi/Regeneron and SunPharma; leadership roles for DeCOG, German Cancer Society, Hiege-Stiftung, Deutsche Hautkrebsstiftung, NVKH e.V. and EuMelaReg. WS reports grants and/or personal fees and/or speaker honoraria from medi GmbH Bayreuth, Abbvie, Almirall, Amgen, Bristol-Myers Squibb, Celgene, GSK, Janssen, LEO Pharma, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi Genzyme und UCB outside the submitted work. SU declares research support from Bristol Myers Squibb and Merck Serono; speakers and advisory board honoraria from Bristol Myers Squibb, Merck Sharp & Dohme, Merck Serono, Novartis and Roche, and travel support from Bristol Myers Squibb, Merck Sharp & Dohme, and Pierre Fabre; outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient flow chart.
See this image and copyright information in PMC

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