Perla Lansang1, James N Bergman2, Loretta Fiorillo3, Marissa Joseph4, Irene Lara-Corrales5, Danielle Marcoux6, Catherine McCuaig6, Elena Pope5, Vimal H Prajapati7, Sue Z J Li8, Ian Landells9. 1. Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. Electronic address: perlalansang@gmail.com. 2. Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada. 3. Division of Pediatric Dermatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. 4. Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 5. Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 6. Division of Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada. 7. Division of Dermatology, Department of Medicine, and Divisions of Community Pediatrics and Pediatric Rheumatology, Department of Pediatrics, University of Calgary; and Dermatology Research Institute, Calgary, Alberta, Canada. 8. Janssen Inc, Toronto, Ontario, Canada. 9. Memorial University of Newfoundland and Nexus Clinical Research, St John's, Newfoundland, Canada.
Abstract
BACKGROUND: Psoriasis is a chronic inflammatory disease with clinical manifestations of the skin that affect adults and children. In adults, biologics have revolutionized the treatment of moderate to severe plaque psoriasis where clear or almost clear is a tangible goal. Research on biologics has recently been extended to children. The introduction of these new therapeutic options has outpaced the limited guidelines in this population. OBJECTIVE: To provide a review of current data on biologics, with a proposal for a clinically relevant treatment algorithm on the management of moderate to severe plaque psoriasis in the pediatric population. METHODS: A Canadian panel with expertise in psoriasis, pediatric dermatology, and experience with consensus recommendation processes was selected to review the current landscape of pediatric psoriasis and clinical data on biologics plus identify special considerations for baseline workup and monitoring. Recommendations were reviewed and edited by each expert in an iterative process. CONCLUSION: A treatment algorithm for moderate to severe plaque psoriasis in pediatric patients is presented, incorporating approved biologics. Guidance on baseline screening and ongoing monitoring is also provided. Ultimately, treatment choice depends on the patient and his or her caregiver, with consideration of comorbidities, impact on quality of life, and relevant safety aspects.
BACKGROUND:Psoriasis is a chronic inflammatory disease with clinical manifestations of the skin that affect adults and children. In adults, biologics have revolutionized the treatment of moderate to severe plaque psoriasis where clear or almost clear is a tangible goal. Research on biologics has recently been extended to children. The introduction of these new therapeutic options has outpaced the limited guidelines in this population. OBJECTIVE: To provide a review of current data on biologics, with a proposal for a clinically relevant treatment algorithm on the management of moderate to severe plaque psoriasis in the pediatric population. METHODS: A Canadian panel with expertise in psoriasis, pediatric dermatology, and experience with consensus recommendation processes was selected to review the current landscape of pediatric psoriasis and clinical data on biologics plus identify special considerations for baseline workup and monitoring. Recommendations were reviewed and edited by each expert in an iterative process. CONCLUSION: A treatment algorithm for moderate to severe plaque psoriasis in pediatric patients is presented, incorporating approved biologics. Guidance on baseline screening and ongoing monitoring is also provided. Ultimately, treatment choice depends on the patient and his or her caregiver, with consideration of comorbidities, impact on quality of life, and relevant safety aspects.
Authors: C Bodemer; A Kaszuba; K Kingo; A Tsianakas; A Morita; E Rivas; P Papanastasiou; D Keefe; M Patekar; P Charef; L Zhang; S Cafoncelli; C Papavassilis Journal: J Eur Acad Dermatol Venereol Date: 2021-01-19 Impact factor: 6.166
Authors: Bhumesh Kumar Katakam; Malathi Munisamy; T Narayana Rao; Minu Jose Chiramel; Maitreyee Panda; Sandeep Gupta; Ranugha Pss; K A Seetharam Journal: Indian Dermatol Online J Date: 2021-11-25
Authors: Klervi Golhen; Carolyn Winskill; Martin Theiler; Michael Buettcher; Yu-Hsin Yeh; Nancy Zhang; Tatjana Welzel; Marc Pfister Journal: Front Med (Lausanne) Date: 2022-09-26