Related Experiment Video

Updated: Dec 26, 2025

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

39.4K

Serious infection risk in children with psoriasis on systemic treatment: A propensity score-matched population-based

Maria C Schneeweiss1, Jennifer T Huang2, Richard Wyss3

  • 1Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Division of Pharmacoepidemiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.

Journal of the American Academy of Dermatology
|March 7, 2020
PubMed

Insights

Children with psoriasis treated with biologics or systemic nonbiologics did not show a significantly higher risk of serious infections compared to phototherapy. Children with psoriasis have an increased infection risk regardless of treatment.

Area of Science:

  • Pediatric Dermatology
  • Infectious Disease Epidemiology
  • Pharmacovigilance

Background:

  • Systemic medications are increasingly used for pediatric psoriasis, but their safety profiles, particularly regarding infections, require further characterization.
  • Understanding infection risks associated with different treatment modalities in children with psoriasis is crucial for informed clinical decision-making.

Purpose of the Study:

  • To estimate the 6-month risk of serious infections in pediatric patients with psoriasis undergoing treatment with biologics, systemic nonbiologics, or phototherapy.
  • To compare the infection risk across these treatment groups and against a background risk in children without psoriasis.

Main Methods:

  • Retrospective analysis of insurance claims data for children under 18 with psoriasis.
  • Comparison of serious infection frequencies between initiators of biologics, systemic nonbiologics, and phototherapy.
  • Propensity score matching (1:1) was employed to adjust for potential confounders and estimate relative risks.

Main Results:

  • The 6-month incidence of serious infections per 1000 patient-years was 4.2 for biologics, 5.1 for systemic nonbiologics, and 1.1 for phototherapy.
  • Relative risks for infection showed no significant differences between biologics versus nonbiologics (0.67) or biologics versus phototherapy (1.50).
  • Children with psoriasis exhibited a nearly twofold higher background risk of infection (1.84) compared to children without psoriasis.

Conclusions:

  • No clinically meaningful difference in serious infection risk was observed between biologic and systemic nonbiologic treatments for pediatric psoriasis.
  • The study found no robust difference in infection risk between systemic treatments (biologics and nonbiologics) and phototherapy.
  • Children with psoriasis are at an elevated risk for infections, irrespective of the specific systemic treatment or phototherapy modality used.
Abstract

Keywords:
epidemiologyimmunomodulating drugsopportunistic infectionspediatricspsoriasissafetyserious bacterial infectionssystemic medications

More Related Videos

Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients02:28

Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients

Published on: March 1, 2024

702
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA

Published on: February 9, 2011

23.5K

Related Concept Videos

Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
13.2K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
143
Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
5.0K
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
156
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
198
Infection01:20

Infection

When a pathogen enters the body and reproduces, it can cause an infection, damage body cells, and cause illness symptoms that eventually lead to disease. Therefore, its prevention requires breaking the chain of infection.
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
11.5K