Giovanni Damiani, MD, discusses one of the notable findings from his EADV Virtual poster on COVID-19 and biologic use, which was the potential protective effect of IL-17 inhibitors.
Dr Damiani is with the department of clinical dermatology at the IRCCS Istituto Ortopedico Galeazzi and is a postdoctoral fellow with the University of Milan in Italy.
A recent study presented at the 29th European Academy of Dermatology and Venereology Congress (EADV Virtual) revealed that biologics may decrease the risk of intensive care unit (ICU) hospitalization and death among patients with psoriasis. In the study, 1193 adult patients with psoriasis treated with biologic or small molecule therapies were compared with the general population of the Lombardy region in Italy. Data were collected from February 21, 2020 (first COVID-19 case), to April 9, 2020. Findings showed that patients treated with biologic therapies had a higher risk of testing positive for SARS-CoV-2 (unadjusted odds ratio [OR], 3.43; 95% CI, 2.25-5.73), being self-quarantined at home (OR, 9.05; 95% CI, 5.61-14.61), and being hospitalized (unadjusted OR, 3.41; 95% CI, 0.21-8.63). Despite the higher risk of testing positive, the researchers found the risk of being admitted to the ICU (unadjusted OR, 3.59; 95% CI, 0.21-54.55) and of death (unadjusted OR, 0.41; 95% CI, 0.03-6.59) were not statically significant.
Thank you for the question. In our experience, all biologics seem to be protective also in population with high level and high prevalence of obesity, COPD, and smoking, all well‑known predictors of poor outcomes in COVID‑19.
In our experience, interleukin‑17 users displayed half of the possibility to get infected in front of all other biological therapy users. That was 0.9 versus 1.8. Furthermore, also the rate of hospitalization was lower.
These clinical findings further empower, there is some findings by Krueger et al that show that ACE‑2 receptor, the main receptor used by COVID‑19 to enter in human body is increased in psoriatic patient, but in particular, in their lesional skin into the plaques.
ACE‑2 expression is correlated with the level of interleukin‑17C. Thus, in clinical practice, they saw also that patients that were responsive to an interleukin‑17 inhibitor such as secukinumab decreased also the ACE‑2 expression that may sustain the hypothesis that interleukin‑17 users had and have lower possibility to get infected.