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Updated: Aug 30, 2025

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

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Biologics for pediatric moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis

I-Hsin Huang1, Chia-Ling Yu2, Cheng-Chen Tai3

  • 1Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|August 26, 2022
PubMed

Insights

Secukinumab-low dose (SEC-L) is the most effective biologic for pediatric psoriasis, achieving high Psoriasis Area and Severity Index (PASI 90) response without increasing adverse events. This finding offers valuable insights for treating young patients with moderate-to-severe psoriasis.

Area of Science:

  • Dermatology
  • Pharmacology
  • Clinical Trials

Background:

  • Pediatric psoriasis affects children with moderate-to-severe skin conditions.
  • Biologic treatments are increasingly used but require efficacy and safety comparisons.
  • Regulatory agencies like the FDA and EMA have approved several biologics.

Purpose of the Study:

  • To compare the efficacy and safety of US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved biologic treatments for pediatric psoriasis.
  • To identify the most effective biologic treatment for achieving significant Psoriasis Area and Severity Index (PASI) improvement.
  • To assess the risk of discontinuation due to adverse events (DAE) associated with these biologics.

Main Methods:

  • A systematic literature search was conducted on MEDLINE, Embase, and Cochrane Central Register of Controlled Trials until May 7, 2021.
  • Eligible randomized controlled trials (RCTs) were included in a fixed-effect frequentist network meta-analysis (NMA).
  • Primary outcomes were Psoriasis Area and Severity Index 90% improvement (PASI 90) at 12-16 weeks and DAE within the same period. Surface under the cumulative ranking curve (SUCRA) was used for ranking.

Main Results:

  • Five RCTs with 798 pediatric patients were analyzed.
  • All investigated biologic regimens demonstrated significantly higher PASI 90 response compared to placebo.
  • Secukinumab-low dose (SEC-L) ranked highest for PASI 90 response (84.7%), followed by ixekizumab (70.8%), with no significant difference in DAE risk across treatments.

Conclusions:

  • Secukinumab-low dose (SEC-L) emerged as the leading biologic treatment for pediatric psoriasis, offering the best PASI 90 response.
  • SEC-L demonstrated favorable efficacy without an increased risk of adverse events leading to discontinuation.
  • Further long-term studies are recommended to fully understand the sustained effects and safety profile of these biologic treatments.
Abstract

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