Use of apremilast does not increase the risk for SARS-CoV-2 infection in patients with psoriasis, investigators reported in a study published in the Journal of the European Academy of Dermatology and Venereology.
The retrospective study was performed at 5 academic and 5 community dermatology practices in Canada. Eligible participants were 18 years of age or older with plaque or pustular psoriasis treated with apremilast.
Data were obtained from patient support program case managers of apremilast and patient-reported outcomes documented by their dermatologist from January 25, 2020, to April 30, 2021. A total of 1,211,083 COVID-19 cases and 24,169 deaths were reported in Canada during this period.
Of 402 patients who were receiving apremilast, no documented COVID-19 cases were found.
The study authors noted that their findings are consistent with phase 3 randomized controlled trials that found that lower respiratory tract infections are rare with short- and long-term apremilast treatment. The researchers theorized that the reduced rate of SARS-CoV-2 infection may be the result of closer adherence to public health guidelines by patients on immunomodulatory therapy or an increased number of asymptomatic carriers who did not undergo COVID-19 testing. Also, patients with COVID-19 who receive apremilast may be less likely to develop severe complications.
The findings are limited by the possibility that patients did not report a positive COVID-19 test result, the relatively small sample size, and the retrospective design. The study also lacked an age-, sex- and diagnosis-matched control group, and demographic information, composition of comorbidities, and differences in protective behaviors that patients on immunosuppression may have were not obtained.
“Our data suggest that discontinuation of apremilast treatment out of concerns for contracting SARS-CoV-2 infection is not supported,” advised the researchers. “In fact, cessation of therapy may lead to a flare of the condition being treated.”
Disclosure: Several of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Lytvyn Y, Georgakopoulos JR, Mufti A, et al. Incidence and prognosis of COVID-19 in patients with psoriasis on apremilast: a multicentre retrospective cohort study. J Eur Acad Dermatol Venereol. Published online October 17, 2021. doi:10.1111/jdv.17749