Targeted Therapy for Pediatric Psoriasis.

Psoriasis is an inflammatory immune-mediated skin disease that affects both adults and children. Increased understanding of its pathogenesis has led to the development of highly effective therapeutic solutions in the form of biological drugs for adult patients with severe forms of the disease. The unpredictability of the action of adult-approved drugs in pediatric populations limited their usage in these patients for several years. However, this scenario has been changing, particularly in the last decade, increasing our knowledge of the clinical efficacy and safety of these drugs in pediatric populations. The approval/extensions to approvals of several biological agents throughout the year 2020 makes it important to update the topic. Five biological agents (etanercept, adalimumab, ustekinumab, secukinumab, and ixekizumab) have been approved by the European Medicines Agency for the treatment of psoriasis in pediatric populations, and three of them (etanercept, ustekinumab, and ixekizumab) were also approved by the US FDA for the same purpose. In total, 17 clinical trials of several distinct targeted therapies (tumor necrosis factor, interleukin [IL]-17 and IL-23, and phosphodiesterase-4 inhibitors) are ongoing in pediatric patients and will certainly provide crucial data on the subject, which could ultimately improve the armamentarium we have to target psoriasis in this special population.