- December 2021 - Medscape Medical News
According to the best available evidence, patients with atopic dermatitis (AD) do not appear to face an increased risk of contracting COVID-19 or being hospitalized because of the virus.
"This is an area that will continue to evolve, and further understanding will improve the health advice we provide to our patients," Jacob P. Thyssen said at the Revolutionizing Atopic Dermatitis virtual symposium. "The general recommendation for now is to continue systemic AD treatments during the pandemic."
According to Thyssen, a professor of dermatology at the University of Copenhagen in Denmark, the AD management guide from the European Task Force on Atopic Dermatitis (ETFAD), the European Academy of Allergology and Clinical Immunology (EAACI) and the International Eczema Council (IEC) states that patients with AD who are taking biological or immunosuppressive drugs should continue treatment if they are not infected with COVID-19.
EAACI guidelines recommend that AD patients with COVID-19 suspend biological treatment for a minimum of 2 weeks until a negative SARS-CoV-2 test results.
The more traditional systemic immunosuppressants in use for the treatment of AD such as azathioprine, cyclosporine and methotrexate suppress the immune system for 1-3 months, Thyssen continued. "We know that the response to vaccination is reduced when using these agents," he said. "The half-life of dupilumab is 12-21 days. It takes about 13 weeks before dupilumab is completely out of the body, but it is such a targeted therapy that it does not lead to extensive immunosuppression."
The half-life of JAK inhibitors such as baricitinib is about 13 hours. "It is a much more specific immunosuppressant than traditional immunosuppressants," he said. "We now have JAK1 and JAK2 inhibitors that do not interfere with vaccine responses to the same extent as traditional immunosuppressants."
To assess the risk of COVID-19 in AD patients, researchers from the Center for Dermatology Research at the University of Manchester, UK, conducted a cross-sectional study of 13,162 dermatology patients and found that the risk of COVID-19 in AD patients was similar to that of controls.