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Updated: Feb 5, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
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Targeted therapies for pediatric psoriasis.
1United States Navy Recruit Training Command/Captain James A. Lovell Federal Health Care Center, North Chicago, Illinois, USA.
Seminars in Cutaneous Medicine and Surgery
|September 15, 2018
Summary
For children with moderate to severe plaque psoriasis unresponsive to topical treatments, systemic therapies like biologics are increasingly used. Biologics offer faster efficacy and fewer side effects than methotrexate but come with higher costs and unknown long-term safety.
Area of Science:
- Pediatric Dermatology
- Immunology
- Pharmacology
Background:
- Psoriasis in children often requires systemic therapy when topical treatments fail.
- Methotrexate has been a traditional systemic agent for pediatric psoriasis.
- Biologic therapies, particularly TNF-α inhibitors, are increasingly utilized in pediatric psoriasis management.
Purpose of the Study:
- To review the current landscape of systemic therapy options for pediatric plaque psoriasis.
- To compare the efficacy, safety, and administration of biologics versus methotrexate.
- To highlight the expanding role and considerations for biologic use in children.
Main Methods:
- Review of current literature and clinical practice guidelines for pediatric psoriasis systemic treatment.
- Comparison of methotrexate with available biologic agents (etanercept, ustekinumab, adalimumab).
- Analysis of drug approvals, efficacy data, side effect profiles, monitoring requirements, and cost considerations.
Main Results:
- Biologics show greater and more rapid efficacy than methotrexate with fewer side effects and less monitoring.
- Biologic approvals vary by region (e.g., US, Europe) and age.
- Despite advantages, biologics are significantly more expensive than methotrexate, require continuous treatment due to antibody development, and have undetermined long-term safety.
Conclusions:
- Biologics represent a growing and effective treatment option for pediatric plaque psoriasis refractory to topical therapy.
- The choice between biologics and methotrexate involves balancing efficacy, safety, monitoring, cost, and long-term unknowns.
- Further research is needed to fully establish the long-term safety profile of biologics in pediatric patients.
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