The following is a summary of “Vaccination recommendations for adults receiving biologics and oral therapies for psoriasis and psoriatic arthritis: Delphi consensus from the medical board of the National Psoriasis Foundation,” published in the June 2024 issue of Dermatology by Chat, et al.
The need for evidence-based recommendations regarding the management of systemic therapies for patients with psoriasis and/or psoriatic arthritis who require nonlive or live vaccines arises. For a study, researchers sought to review the vaccine efficacy and safety literature and develop consensus-based recommendations for adults on systemic therapies for psoriasis and psoriatic arthritis undergoing nonlive or live vaccinations.
A modified Delphi process engaged experts from the National Psoriasis Foundation Medical Board, COVID-19 Task Force, and infectious disease field to create 22 consensus statements.
Key recommendations suggested maintaining most oral and biologic therapies without alteration for patients receiving nonlive vaccines, with possible methotrexate interruption. Regarding live vaccines, cessation of most oral and biologic medications before and after administration is advised. Specific guidance includes halting most biologic therapies (excluding abatacept) for 2-3 half-lives before administering live vaccines and delaying the next dose for 2-4 weeks post-live vaccination. The need for studies examining infection rates post-vaccination poses a challenge in establishing recommendations.
Temporary cessation of antipsoriatic oral and biological therapies is generally unnecessary for patients undergoing nonlive vaccinations. However, temporary discontinuation of oral and biological therapies before and after vaccination is generally recommended for those receiving live vaccines.
Reference: jaad.org/article/S0190-9622(24)00243-3/abstract
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