Anti-TNF agents for paediatric psoriasis.

Area of Science:

• Dermatology
• Immunology
• Pediatrics

Background:

• Psoriasis is a chronic skin condition affecting children, with some cases requiring systemic treatment.
• Biological agents, specifically anti-tumour necrosis factor (anti-TNF) drugs, are used for moderate to severe psoriasis.
• Limited evidence exists on the safety and efficacy of anti-TNF agents in pediatric psoriasis.

Purpose of the Study:

• To evaluate the efficacy and safety of anti-TNF agents for treating pediatric psoriasis.
• To synthesize available evidence on biological therapies for children with psoriasis.

Main Methods:

• A systematic literature search was conducted across multiple databases up to July 2015.
• Included were randomized controlled trials (RCTs) assessing anti-TNF agents in individuals under 18 with chronic plaque psoriasis.
• Primary outcomes included Psoriasis Area and Severity Index 75 (PASI 75) improvement, quality of life (CDLQI), and adverse events.

Main Results:

• One RCT involving 211 participants (median age 13) evaluated etanercept versus placebo.
• Etanercept significantly improved PASI 75 scores (57% vs 11%) and Children's Dermatology Life Quality Index (CDLQI) at 12 weeks.
• No short-term serious adverse events were reported; etanercept demonstrated a favorable safety profile in this study.

Conclusions:

• Based on a single RCT, etanercept appears efficacious and safe for short-term treatment of pediatric psoriasis.
• The study highlighted a low risk of bias for most outcomes, but a high risk of publication bias due to industry sponsorship.
• Further research with standardized outcomes and long-term follow-up is recommended to confirm findings and evaluate safety comprehensively.