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Dermbits

MD, PhD

Can you comment on the impact of biologics on COVID vaccine efficacy?

Psoriasis

You. So one of the big questions that has arisen among our patients treated with biologics is what do we tell them about getting vaccinated? So, one, we certainly are telling patients, if you're on a biologic, you should certainly be vaccinated against Covid. We have had some recent studies that have given us some information about how those patients respond. And so I think that one of the most interesting studies looked at the response to the Pfizer mrna vaccine, and they found that patients on tnf inhibitors, IL 17 and IL 23 inhibitors, compared to healthy controls, really had very similar antibody titers to the vaccine and neutralizing antibody activity. They also looked at patients with methotrexate. Their antibody levels and neutralizing activity were slightly lower, but still were adequate. Now, the other thing that this study looked at was they looked at t cell responses, and interestingly, they found that t cell responses across all those therapies, biologic methotrexate really were comparable to those in healthy controls. So I think it really does suggest that patients on biologics for psoriasis will mount a good vaccine response. They should be encouraged to get vaccinated. I will say that other studies that have looked at other biologics that we use in dermatology, specifically b cell depleting therapies like rituximab, that is a drug that really does impair vaccine responses. So patients who have had rituxim map, particularly those who've had it within the past six months, are unlikely to mount a good vaccine response. They should be counseled to use good social distancing and precautions, and it probably makes sense to monitor titers in those patients.