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Thanks to their specificity of action, biologic drugs often lead to complete clearance of psoriatic lesions. In order to maintain its effectiveness, biological therapies cannot be discontinued. The aim of the study was to investigate the effect of widening the administration window of four biologic drugs, thus improving the quality of life of psoriatic patients and satisfying their desire to feel free from the disease, without loss of effectiveness. We performed a multicentric cohort study considering patients with moderate-severe plaque psoriasis and/or arthropathic psoriasis treated with infliximab, adalimumab, etanercept or ustekinumab. The study group included patients with stabilized psoriasis in which the administration regimen of the biologic drug was deferred. The control group included psoriatic patients treated according the product monograph. The percentage of relapses in case of deferred administration intervals was comparable to that of standard administration intervals. The delayed administration modality got a good psychological consensus from the patients themselves, that reported a greater 'perceived satisfaction'. A consistent economic advantage was reported in case of prolonged administration intervals. The administration of biologic drugs with prolonged intervals maintains the same effectiveness as standard administration and produces a 'perceived satisfaction' in psoriatic patients. [ABSTRACT FROM AUTHOR]

Rituximab, a chimeric monoclonal antibody that targets the CD-20 molecule on B-cells' surface, has led to significant advances in the treatment of autoimmune pemphigus in recent decades. The aim of the study was to assess the clinical efficacy as well as safety data for biosimilar rituximab with emphasis on the treatment of pemphigus vulgaris. A total of 12 individuals with pemphigus vulgaris treated with biosimilar rituximab were followed for at least 1 year. We assessed patient characteristics, disease history, pemphigus disease area index (PDAI) score, anti-desmoglein (Dsg)1 and anti-Dsg3 antibody level, clinical response, and any adverse events during each clinical follow-up visit. We also recorded time to achieve complete remission, duration of complete remission and time to relapse. A consistent decrease in the PDAI score was observed (p<.0001), as well as a significant decrease of anti-Dsg3 values. In addition, the clinical response of this population confirmed that the equivalent is not inferior to Rituximab (p=.521). The introduction or the switch to Rixathon, a rituximab biosimilar, appears to be safe and may provide an opportunity to reduce health system costs because of its similarity to the reference drug in terms of safety and efficacy. [ABSTRACT FROM AUTHOR]

From March 9, 2020, our outpatient service was temporarily suspended and replaced by phone call to patients, asking if they had discontinued therapy and/or had suffered from any COVID-19 related symptoms since February. On the contrary, the prompt discontinuation of immunomodulant/immunosuppressant therapies and rituximab is mandatory in cases of moderate-severe respiratory symptoms or contact history with COVID-19 patients, until swab-confirmed negativity for COVID-19 and complete remission of respiratory symptoms. Dear Editor, There are different opinions about the management of ongoing immunosuppressant/immunomodulant therapies during the COVID-19 outbreak ([[1], [3]]). [Extracted from the article]

Specifically, the Italian official indications suggest that if the patient is stable or in good health it is not reasonable/indicated to suspend the ongoing immunosuppressive/immunomodulatory therapy, as the risk of reactivation of the underlying pathology could add an additional risk factor to infections, including COVID-19. It is necessary to collect as many cases as possible related to psoriasis patients in biological therapy who have contracted COVID-19, in order to better quantify the risk of infection under biologic therapy. [Extracted from the article]