PeDRA Lists Systemics With Higher COVID-19 Risk

According to a recent Pediatric Dermatology Research Alliance (PeDRA) statement, some systemic medications may have increased risk for patients during the COVID-19 era. The immunosuppressant medications listed below may carry a higher risk of infection than those considered more immunomodulating (eg, low-dose methotrexate, apremilast [Otezla; Amgen]. The risk of infection also varies among the biologic agents.

Immunosuppressant medications:

• Small molecules
  • Corticosteroids (eg, prednisone, prednisolone, methylprednisolone)
  • Cyclosporine
  • Mycophenolate mofetil
  • Tacrolimus
  • Azathioprine
• Biologics
  • Anti-CD20 (pan–B cell) rituximab [Rituxan; Genetech]
  • Tumor necrosis factor inhibitors (eg, etanercept [Enbrel; Amgen], adalimumab, infliximab [Avsola; Amgen]
  • IL-17 inhibitors (eg, secukinumab [Cosentyx; Novartis], ixeki-zumab [Taltz; Eli Lilly and Company]
  • IL-12/IL-23 inhibitor ustekinumab [Stelara; Janssen Pharmaceuticals]

It may be safer to continue rather than discontinue these or other medicines for children with moderate to severe skin disease, according to PeDRA. Providers should weigh whether the risk of a worsening skin condition when off the medicine is greater than the risk of COVID-19 infection and severe health consequences of an infection.

Source: PeDRA. General information for patients and caregivers about COVID-19. Updated May 11, 2020. Accessed June 24, 2021. General Information for Patients and Caregivers about COVID-19 (pedraresearch.org).

Reviewed June 30, 2021, for Dermatology Times® by Elaine Siegfried, MD, professor of pediatrics and dermatology at Saint Louis University Doisy College of Health Sciences and director of pediatric dermatology at Cardinal Glennon Children’s Hospital in St Louis, Missouri.