Table 2.

Considerations for use of psoriasis biologic medications during the COVID-19 pandemic

Factors favoring biologic discontinuation or reduction in immunomodulatory regimen	Factors favoring biologic continuation
Any active infection, including COVID-19	Young age
COVID-19 risk factors including: age > 60, cardiovascular disease, hypertension, lung disease, diabetes, or cancer	No COVID-19 high risk co-morbidities
Concomitant immunosuppression (e.g., methotrexate, prednisone, cyclosporine)	Biologic monotherapy
Immunosuppressive condition (e.g., HIV)	Severe underlying psoriasis or psoriatic arthritis, with history of rapid flares or unstable subtypes (pustular, erythrodermic)
History of infections while on biologic	No concomitant immunosuppressive conditions
Mild-to-moderate underlying psoriasis	Low risk of exposure to COVID-19 virus
High risk of exposure to COVID-19 virus (e.g., endemic area, healthcare worker, nursing home resident, household member or co-worker with COVID-19 infection)	Long duration of COVID-19 pandemic
Short duration of COVID-19 pandemic