TY - JOUR
T1 - The effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis
T2 - Results from the global SECURE-AD registry
AU - Musters, Annelie H.
AU - Broderick, Conor
AU - Prieto-Merino, David
AU - Chiricozzi, Andrea
AU - Damiani, Giovanni
AU - Peris, Ketty
AU - Dhar, Sandipan
AU - de, Abhishek
AU - Freeman, Esther
AU - Arents, Bernd W. M.
AU - Burton, Tim
AU - Bosma, Angela Leigh-Ann L.
AU - Chi, Ching-Chi
AU - Fletcher, Godfrey
AU - Drucker, Aaron M.
AU - Kabashima, Kenji
AU - de Monchy, Emilie F.
AU - Panda, Maitreyee
AU - Wall, Dmitri Robert
AU - Vestergaard, Christian
AU - Mahé, Emmanuel
AU - Bonzano, Laura
AU - Kattach, Leila
AU - Napolitano, Maddalena
AU - Ordoñez-Rubiano, María Fernanda
AU - Haufe, Eva
AU - Patruno, Cataldo
AU - Irvine, Alan D.
AU - Spuls, Phyllis I.
AU - Flohr, Carsten
N1 - Funding Information: The authors would like to thank the National Institute for Medical Research Development (NIMAD) for the financial support of this work (Grant No. 942974). The authors would also like to acknowledge Dr. Fatemeh Jamshidi Adegani for her mentorship role in this project and Dr. Marie Shamseddin for native English review. Funding Information: We are very grateful to all healthcare professionals who have reported cases to the SECURE-AD Physician Registry. We would also like to acknowledge our partner organizations and related registries who supported or promoted the SECURE-AD registry. We are particularly grateful to the following: Members of the SECURE-AD International Scientific Advisory Committee: Sebastien Barbarot MD PhD, Esther Freeman MD PhD, Emma Guttman MD PhD, USA (IEC), Jo Lambert MD PhD, Tamar Nijsten MD PhD, Amy Paller MD, Carle Paul MD PhD, Alain Taieb MD PhD, Andreas Wollenberg MD PhD, Christian Vestergaard MD PhD, Andrea Chiricozzi MD, Ketty Peris MD; All healthcare professionals who have submitted one or more cases in the SECURE-AD registry: Eleni Anthony, Valeria Aoki, Esther Baldrich, Alberto Barea, Paula Beattie, Anthony Bewley, Andrew Blauvelt, Andrea Carugno, Cécile Morice, Petra Cetkovska, Aisling Clery, Katerina Damevska, Vincent Descamps, Jitske Dijkstra, Roni Dodiuk-Gad, Marta Elosua-González, Felicity Ferguson, Susannah George, Tina Haase, Mariana Hernandez Flores, Ai Shuen Hew, Philipp Hinteregger, Manrip Hunjan, Jing Husaini, Ariënna Hyseni, Karina Jackson, Erin Kamp, Jasbinder Kaur, Dimitra Kiritsi, Emek Kocatürk, Sinead Langan, Yael Leshem, Peter Lio, Clodagh Loftus, Paula Luna, Teena Mackenzie, Satveer Mahil, Alexander Marsland, Valeria Mateeva, Zeljko Mijuskovic, Nicola Milanesi, Lucy Moorhead, Esra Musbahi, John Newsham, Jane O'Connor, Swetlina Pradhan, Amy Paller, Bibiana Pérez García, Anke Piekar, Nadia Raison-Peyron, Giulia Rech, Pawinee Rerknimitr, Rosalind Simpson, Sahana Srinivas, Katarzyna Stankiewicz-Sojka, Ting Seng Tang, Efstratios Vakirlis, Richard Weller, Richard Woolf, Zenas Yiu; Our partner organizations: British Association of Dermatologists (BAD), European Society for Dermatological Research (ESDR), International League of Dermatological Societies (ILDS), European Task Force on Atopic Dermatitis (ETFAD), International Eczema Council (IEC), Skin Inflammation & Psoriasis International Network (SPIN), European Dermato-Epidemiology Network (EDEN), European Academy of Dermatology and Venereology (EADV), International Society of Atopic Dermatitis (ISAD), TREatment of ATopic eczema (TREAT) Registry Taskforce, TREatment of ATopic eczema – The Netherlands (TREAT NL) Registry, The UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR), Nederlandse Vereniging voor Dermatologie en Venereologie (NVDV), Japanese Dermatological Association (JDA), National Eczema Association (NES); National and International Skin Registry Solutions (NISR) CLG for their support and expertise which enabled rapid development, deployment and maintenance of the registry platform and harmonization effort; The related COVID-registries: SECURE-AD Patient Survey, AAD COVID-19 registry, DA-COVID-19 registry, SECURE-Alopecia, PsoProtect, SECURE-Psoriasis, SECURE-IBD, COVID-19 Global Rheumatology Alliance. Publisher Copyright: © 2022 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
PY - 2023/2
Y1 - 2023/2
N2 - Background: Limited data are available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis (AD). Objective: To investigate COVID-19 outcomes in patients with AD treated with or without systemic immunomodulatory treatments, using a global registry platform. Methods: Clinicians were encouraged to report cases of COVID-19 in their patients with AD in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Atopic Dermatitis (SECURE-AD) registry. Data entered from 1 April 2020 to 31 October 2021 were analysed using multivariable logistic regression. The primary outcome was hospitalization from COVID-19, according to AD treatment groups. Results: 442 AD patients (mean age 35.9 years, 51.8% male) from 27 countries with strongly suspected or confirmed COVID-19 were included in analyses. 428 (96.8%) patients were treated with a single systemic therapy (n = 297 [67.2%]) or topical therapy only (n = 131 [29.6%]). Most patients treated with systemic therapies received dupilumab (n = 216). Fourteen patients (3.2%) received a combination of systemic therapies. Twenty-six patients (5.9%) were hospitalized. No deaths were reported. Patients treated with topical treatments had significantly higher odds of hospitalization, compared with those treated with dupilumab monotherapy (odds ratio (OR) 4.65 [95%CI 1.71–14.78]), including after adjustment for confounding variables (adjusted OR (aOR) 4.99 [95%CI 1.4–20.84]). Combination systemic therapy which did not include systemic corticosteroids was associated with increased odds of hospitalization, compared with single agent non-steroidal immunosuppressive systemic treatment (OR 8.09 [95%CI 0.4–59.96], aOR 37.57 [95%CI 1.05–871.11]). Hospitalization was most likely in patients treated with combination systemic therapy which included systemic corticosteroids (OR 40.43 [95%CI 8.16–207.49], aOR 45.75 [95%CI 4.54–616.22]). Conclusions: Overall, the risk of COVID-19 complications appears low in patients with AD, even when treated with systemic immunomodulatory agents. Dupilumab monotherapy was associated with lower hospitalization than other therapies. Combination systemic treatment, particularly combinations including systemic corticosteroids, was associated with the highest risk of severe COVID-19.
AB - Background: Limited data are available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis (AD). Objective: To investigate COVID-19 outcomes in patients with AD treated with or without systemic immunomodulatory treatments, using a global registry platform. Methods: Clinicians were encouraged to report cases of COVID-19 in their patients with AD in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Atopic Dermatitis (SECURE-AD) registry. Data entered from 1 April 2020 to 31 October 2021 were analysed using multivariable logistic regression. The primary outcome was hospitalization from COVID-19, according to AD treatment groups. Results: 442 AD patients (mean age 35.9 years, 51.8% male) from 27 countries with strongly suspected or confirmed COVID-19 were included in analyses. 428 (96.8%) patients were treated with a single systemic therapy (n = 297 [67.2%]) or topical therapy only (n = 131 [29.6%]). Most patients treated with systemic therapies received dupilumab (n = 216). Fourteen patients (3.2%) received a combination of systemic therapies. Twenty-six patients (5.9%) were hospitalized. No deaths were reported. Patients treated with topical treatments had significantly higher odds of hospitalization, compared with those treated with dupilumab monotherapy (odds ratio (OR) 4.65 [95%CI 1.71–14.78]), including after adjustment for confounding variables (adjusted OR (aOR) 4.99 [95%CI 1.4–20.84]). Combination systemic therapy which did not include systemic corticosteroids was associated with increased odds of hospitalization, compared with single agent non-steroidal immunosuppressive systemic treatment (OR 8.09 [95%CI 0.4–59.96], aOR 37.57 [95%CI 1.05–871.11]). Hospitalization was most likely in patients treated with combination systemic therapy which included systemic corticosteroids (OR 40.43 [95%CI 8.16–207.49], aOR 45.75 [95%CI 4.54–616.22]). Conclusions: Overall, the risk of COVID-19 complications appears low in patients with AD, even when treated with systemic immunomodulatory agents. Dupilumab monotherapy was associated with lower hospitalization than other therapies. Combination systemic treatment, particularly combinations including systemic corticosteroids, was associated with the highest risk of severe COVID-19.
UR - http://www.scopus.com/inward/record.url?scp=85139612267&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jdv.18613
DO - https://doi.org/10.1111/jdv.18613
M3 - Article
C2 - 36169355
SN - 0926-9959
VL - 37
SP - 365
EP - 381
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
IS - 2
ER -