Prevalence and Incidence of COVID-19 Infection in Patients With Chronic Plaque Psoriasis on Immunosuppressant Therapy

Overview

This study will assess the prevalence and incidence of COVID-19 infection in patients with chronic plaque psoriasis on immunosuppressant therapy.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: November 2020

Detailed Description

The ongoing COVID-19 pandemic has hit Northern Italy (including the Veneto region) particularly hard, causing several deaths and putting a huge strain on the Italian National Healthcare System. In the absence of specific treatments, preventing the infection from spreading remains the only effective measure. There is a lot of apprehension both from doctors (including dermatologists, rheumatologists and gastroenterologists) and their patients that immunosuppressive medications (biologics, methotrexate, ciclosporin and corticosteroids) might lead to an increased susceptibility to COVID-19 infection or negatively influence the course of the infection. However, there is currently a lack of scientific evidence to recommend whether immunosuppressive treatments should or should not be continued in patients who have no symptoms of COVID-19 infection. Besides, treatment discontinuation would cause flare-ups of diseases – such as plaque psoriasis, psoriatic arthritis and inflammatory bowel diseases – which are invalidating and have a relatively high prevalence in the Veneto population. In the Unit of Dermatology of the Azienda Ospedaliera Universitaria Intergrata di Verona alone, more than 2000 patients are currently being treated with immunosuppressive agents. As of now, there are no data available on the prevalence and incidence of COVID-19 infection in patients with immune-mediated diseases, nor can data from randomized clinical trials be extrapolated to the susceptibility to COVID-19 infection in patients on biologic drugs. This study aims to assess the prevalence and incidence of COVID-19 infection in patients with chronic plaque psoriasis on immunosuppressive therapy and to identify associated risk factors. Such data would prove invaluable for clinicians dealing with patients on immunosuppressive agents during the coronavirus outbreak.

Interventions

  • Diagnostic Test: Nasopharyngeal swab
    • Nasopharyngeal swab for the molecular diagnosis of COVID-19 infection

Arms, Groups and Cohorts

  • Group 1
    • Patients with chronic plaque psoriasis on immunosuppressant therapy
  • Group 2
    • Psoriatic patients’ partners
  • Group 3
    • Patients with atopic dermatitis treated with dupilumab

Clinical Trial Outcome Measures

Primary Measures

  • Point prevalence of COVID-19 infection
    • Time Frame: Baseline up to 6 months

Secondary Measures

  • Incidence of COVID-19 infection
    • Time Frame: Baseline up to 6 months
  • Percentage of subjects presenting fever or respiratory symptoms
    • Time Frame: Baseline up to 6 months
  • Evaluate the relationship between COVID-19 infection and chronic pharmacological treatments
    • Time Frame: Baseline up to 6 months
  • Evaluate the relationship between COVID-19 infection and comorbid medical conditions
    • Time Frame: Baseline up to 6 months

Participating in This Clinical Trial

Group 1 Inclusion Criteria:

  • Aged 18 to 75 years old – Individuals with a clinical diagnosis of moderate-to-severe chronic plaque psoriasis confirmed by the Investigator – Continuous immunosuppressive therapy (etanercept, adalimumab, infliximab, ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, apremilast, methotrexate, ciclsoporin, acitretin) for the past 3 months – Is willing and able to sign informed consent to participate Exclusion Criteria:

  • Patients unwilling to undergo noasopharyngeal swab – Inability to give informed consent Group 2 Inclusion Criteria:

  • Aged 18 to 75 years old – Partner of a patient with psoriasis enrolled in the study – Is willing and able to sign informed consent to participate Exclusion Criteria:

  • Personal history of psoriasis – Ongoing immunosuppressive therapy – Patients unwilling to undergo noasopharyngeal swab – Inability to give informed consent Group 3 – Aged 18 to 75 years old – Individuals with a clinical diagnosis of moderate-to-severe atopic dermatitis confirmed by the Investigator – Continuous therapy with dupilumab for the past 3 months – Is willing and able to sign informed consent to participate Exclusion Criteria:

  • Patients unwilling to undergo noasopharyngeal swab – Inability to give informed consent

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 75 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Universita di Verona
  • Collaborator
    • Azienda Ospedaliera Universitaria Integrata Verona
  • Provider of Information About this Clinical Study
    • Principal Investigator: Paolo Gisondi, Associate Professor – Universita di Verona
  • Overall Contact(s)
    • Paolo Gisondi, +39 0458122547, paolo.gisondi@univr.it

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