The National Psoriasis Foundation (NPF) COVID-19 Task Force updated their guidance statements for the optimal management of psoriatic disease during the COVID-19 pandemic. The latest recommendations were published in the Journal of the American Academy of Dermatology.
The task force includes expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care from different geographical areas within the United States and Canada, and the group is supported by several nonvoting members. They previously released an earlier version of the guidance in September 2020.
In version two of their guidance, the task force updated evidence for the original 22 statements and added five more recommendations. Three new additions include:
- Guidance 4.5, which states that patients with psoriatic disease, who do not have contraindications to vaccination, should receive a mRNA-based vaccine as soon as it is available to them based on their local, state, and federal guidance for prioritization.
- Guidance 4.6, which states that patients who are to receive a mRNA-based SARS-CoV-2 vaccine should continue their biologic or oral therapies for the ongoing management of their psoriatic disease in most cases.
- Guidance 5.4.3, which states that ivermectin is not recommended for the prevention or treatment of COVID-19 in this patient population outside of a clinical trial.
Among the updates included an important clarification of guidance 5.2, which details recommendations regarding treatment options for COVID-19 in patients with psoriasis or psoriatic arthritis. Version two breaks the evidence-based therapies into outpatient vs hospitalized treatments to be used alongside supportive care.
For patients with psoriasis, outpatient options include casirivimab and imdevimab administered concomitantly or bamlanivimab. These are options are optimal for patients who are at a high risk of progressing to a more severe disease course and/or hospitalization, among other specific criteria.
Patients who have already been hospitalized and who meet specific criteria may receive:
- Baricitinib in combination with remdesivir
The task force highlights that the care of hospitalized patients with psoriatic disease should include consultation with a multidisciplinary care team, including dermatologist, rheumatologists, and/or infectious disease specialists as medically necessary.
Gelfand JM, Armstrong AW, Bell S, et al. 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. J Am Acad Dermatol. Published online January 6, 2021. doi:10.1016/j.jaad.2020.12.058