COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

• Published in: Frontiers in immunology Vol. 14; p. 1107438
• Main Authors: Lodde, Georg Christian, Krefting, Frederik, Placke, Jan-Malte, Schneider, Lea, Fiedler, Melanie, Dittmer, Ulf, Becker, Jürgen Christian, Hölsken, Stefanie, Schadendorf, Dirk, Ugurel, Selma, Sondermann, Wiebke
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 16-03-2023
• Subjects: Antibodies, Viral; biologics; Cohort Studies; COVID-19 - prevention & control; COVID-19 Vaccines; Humans; Immunoglobulin G; Immunology; Methotrexate; Middle Aged; Prospective Studies; psoriasis; Psoriasis - drug therapy; psoriasis treatment; seroconversion; Tumor Necrosis Factor-alpha; COVID-19 vaccines; psoriasis treatment; biologics; seroconversion; psoriasis
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2023.1107438

The rate of seroconversion after COVID-19 vaccination in patients with moderate to severe psoriasis requiring systemic treatment is poorly understood.
The aim of this prospective single-center cohort study performed between May 2020 and October 2021 was to determine the rate of seroconversion after COVID-19 vaccination in patients under active systemic treatment for moderate to severe psoriasis.
Inclusion criteria were systemic treatment for moderate to severe psoriasis, known COVID-19 vaccination status, and repetitive anti-SARS-CoV-2-S IgG serum quantification. The primary outcome was the rate of anti-SARS-CoV-2-S IgG seroconversion after complete COVID-19 vaccination.
77 patients with a median age of 55.9 years undergoing systemic treatment for moderate to severe psoriasis were included. The majority of patients received interleukin- (n=50, 64.9%) or tumor necrosis factor (TNF)-α inhibitors (n=16, 20.8%) as systemic treatment for psoriasis; nine patients (11.7%) were treated with methotrexate (MTX) monotherapy, and one patient each received dimethyl fumarate (1.3%), respectively apremilast (1.3%). All included patients completed COVID-19 vaccination with two doses over the course of the study. Serum testing revealed that 74 patients (96.1%) showed an anti-SARS-CoV-2-S IgG seroconversion. While all patients on IL-17A, -12 or -12/23 inhibitors (n=50) achieved seroconversion, three of 16 patients (18.8%) receiving MTX and/or a TNF-α inhibitor as main anti-psoriatic treatment did not. At follow-up, none of the patients had developed symptomatic COVID-19 or died from COVID-19.
Anti-SARS-CoV-2-S IgG seroconversion rates following COVID-19 vaccination in psoriasis patients under systemic treatment were high. An impaired serological response, however, was observed in patients receiving MTX and/or TNF-α inhibitors, in particular infliximab.