During the COVID-19 pandemic, many patients with psoriatic disease faced several challenges to their management, including inconsistent follow-up and variability in biologic initiation and discontinuation, according to research findings published in the Journal of Cosmetic Dermatology.

The retrospective study was an analysis of 1525 patients with psoriatic disease from a single dermatology clinic in Turkey. Patients were managed from December 2019 to August 2020. In the analysis, the researchers examined the affect the COVID-19 pandemic had on patients with psoriatic disease in terms of changes in hospital admissions and treatment adherence. Patients were categorized based on their admission dates, which included categories termed pre-COVID-19 (PC; n=1084), early COVID-19 (EC; n=169), and late COVID-19 (LC; n=246).

Although several patients discontinued during the EC period, the most noticeable drop occurred in patients treated with biologic agents. Approximately 15.2% of all patients from the PC period (n=165) made admission for biologic agents, including 17 who were first-time biologic agents users. A total of 14 of 196 (7.1%) patients made admission for biologic agents, including 3 patients who were first-time biologic agent users. There were 18 patients at the end of the LC period who were using biologic agents, including 4 who were first-time users of these agents.


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During the pandemic, all patients with psoriatic disease experienced follow-up interruptions to some extent. The rate of treatment interruption was significantly higher in patient treated with biologic agents compared with patients who were treated with other modalities, including a phototherapy, topical therapies, and nonbiological system treatments (P <.001). Up to 8.5% of patients who were treated with biologic agents at the PC period arrived to follow-up at the EC period, and 18.1% of patients who were treated with other therapies came to the follow-up at the EC period.

In an analysis of patients who continued their biologic agents vs those who discontinued or interrupted their biologic agents during the EC and LC periods, no significant difference was found between the groups in terms of age (P =.12), sex (P =.31), disease duration (P =.71), biologic duration (P =.51), Psoriasis Area and Severity Index (P =.1), and presence of psoriatic arthritis (P =.13).

The researchers reported variability in the percentages of patients who initiated biologic agents between the study periods. For example, 10.2% of patients during the PC period who started biologic agents were new users to a biologic therapy. This increased to 21.4% during the EC period and 22.2% during the LC period.

Limitations of the study included its retrospective nature as well as the single-center design that included patients from only 1 dermatology clinic in Turkey.

The researchers believe that the reduction in follow-up among these patients during the COVID-19 pandemic may have been related to regulations designed to help lower hospital admissions during the EC and LC periods. During these periods, patients with psoriatic disease were able to receive their prescribed biologic agents. “Reduction of patient follow-up for all psoriatic patients may cause disease deterioration,” the researchers added, “and this may cause rise of biologic initiation as showed in our study.”

Reference

Özdemir AK, Hayran Y, Şen O, Aktaş A. Effect of COVID-19 pandemic on psoriatic patients dermatology admissions and biologic treatment adherences: A single-center retrospective study. J Cosmet Dermatol. Published online October 11, 2021. doi:10.1111/jocd.14512