Talking safety in treating psoriatic disease with biologics

Episode overview

The increased risk of adverse events, especially serious infections, is one of the greatest concerns for dermatologists and rheumatologists when choosing from the available biologics. In this episode, our expert speaker and co-hosts discuss the risk of infections associated with biologic therapies, and you can peek behind the curtain of their clinics for guidance on managing patients with psoriatic disease.

The conversation is spread over four parts:

1: Biologics and infection: which patient is at high risk?
2: Treating patients with a history of cancer
3: Biologic treatment for psoriasis/PsA and COVID-19 vaccination
4: Biologics in pregnancy and breastfeeding: are they safe?

Faculty

Podcast co-hosts:

Dr Alexander Egeberg
Associate professor of dermatology, and head of the psoriasis clinic at Bispebjerg Hospital in Copenhagen, Denmark.

Professor Carlo Selmi
Professor and head of the Rheumatology and Clinical Immunology Unit at the Humanitas Hospital in Milan, Italy.

Expert speaker:

Professor Doug Veale
Professor of Medicine, Director of Translational Research, and Consultant Rheumatologist at St Vincent’s University Hospital in Dublin, Ireland. Lead of the EULAR (European Alliance of Associations for Rheumatology) Centre of Excellence for Arthritis and Rheumatic Diseases.


Part 1: Biologics and infection: which patient is at high risk?
Infections are the key concern in terms of safety when treating patients with psoriasis and psoriatic arthritis (PsA). Curious about how Prof. Veale recommends screening the patients before starting a biologic and during treatment? Don’t miss this video!

References:
Blauvelt A, Tsai TF, Langley RG, et al. J Am Acad Dermatol. 2022;86(4):827-34.
Gomes CMF, Terreri MT, Moraes-Pinto MI, Pinheiro MM. Adv Rheumatol. 2021;61(1):71.
Holroyd CR, Seth R, Bukhari M, et al. Rheumatology (Oxford). 2019;58(2):e3-42.
Kaushik SB, Lebwohl MG. J Am Acad Dermatol. 2019;80(1):43-53.
McInnes IB, Rahman P, Gottlieb AB, et al. Arthritis Rheumatol. 2022;74(3):475-85.
Nast A, Smith C, Spuls PI, et al. J Eur Acad Dermatol Venereol. 2021;35(2):281-317.
Ritchlin CT, Mease PJ, Boehncke WH, et al. RMD Open. 2022;8(1):e002195.
Smith CH, Yiu ZZN, Bale T, et al. Br J Dermatol. 2020;183(4):628-37.

Part 2: Treating patients with a history of cancer
Is there an increased risk of cancer in patients with psoriasis and PsA? What are the considerations in giving biologics to patients with a history of cancer or currently undergoing cancer therapy? Make sure you watch this video to find out!

References:
Mleczko M, Gerkowicz A, Krasowska D. Int J Mol Sci. 2022;23(3):1767.
Reich K, Papp KA, Blauvelt A, et al. Lancet. 2021;397(10273):487-98.
Seror R, Lafourcade A, De Rycke Y, et al. RMD Open. 2022;8(2):e002139.
Thatiparthi A, Martin A, Liu J, et al. Am J Clin Dermatol. 2021;22(4):425-42.
Vaengebjerg S, Skov L, Egeberg A, Loft ND. JAMA Dermatol. 2020;156:421-9.

Part 3: Biologic treatment for psoriasis/PsA and COVID-19 vaccination
We can’t talk about infections in 2022 without mentioning and discussing COVID-19. Do biologic treatments affect COVID-19 outcome? What safety concerns do patients with psoriasis and PsA have regarding vaccination? Tune in to find out!


References:
Feldmann M, Maini RN, Woody JN, et al. Lancet. 2020;395(10234):1407-9.
Gianfrancesco M, Hyrich KL, Al-Adely S, et al. Ann Rheum Dis. 2020;79(7):859-66.
Jones ME, Kohn AH, Pourali SP, et al. Dermatol Clin. 2021;39(4):545-53.
Jones SA, Hunter CA. Nat Rev Immunol 2021;21:337-9.

Part 4: Biologics in pregnancy and breastfeeding: are they safe?
In this segment, our experts talk about the recommendations and safety of biologics in women with psoriatic disease. Listen to our experts’ personal experience in treating women who are wanting to become pregnant, are pregnant or are breastfeeding.

References:
Beltagy A, Aghamajidi A, Trespidi L, et al. Front Pharmacol. 2021;12:621247.
Murray K, Moore L, McAuliffe F, Veale DJ. Ann Rheum Dis. 2019;78(6):850-2.
Public Health England. Rotavirus: the green book, chapter 27b. Rotavirus immunisation information for public health professionals. Guidance. Immunisation and Countermeasures Division, PHE. September 2021.