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Published on: July 11, 2013
The Efficacy, Safety and Longevity of Biologic Treatments in Pediatric and Adult Psoriasis Patients: A Comparative
Özlem Akın Çakıcı1, Zeynep Topkarcı2, Begüm Yurtsever Güneş3
1Department of Dermatology, Marmara University School of Medicine, Istanbul, Republic of Türkiye. ozlm_akin@hotmail.com.
Insights
Biologic therapies like etanercept and ustekinumab show comparable efficacy and safety in pediatric and adult psoriasis patients. Drug survival rates were similar, with no significant safety concerns identified in children for long-term use.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Limited data exists on the long-term effectiveness, safety, and drug survival of biologic therapies in pediatric psoriasis.
- Psoriasis affects both children and adults, necessitating a comparison of treatment outcomes across age groups.
Purpose of the Study:
- To compare the efficacy, safety, and drug survival rates of six biologic agents (etanercept, adalimumab, infliximab, ustekinumab, secukinumab, ixekizumab) in pediatric and adult psoriasis patients.
- To evaluate the long-term usability and tolerability of these biologics in younger populations.
Main Methods:
- A retrospective analysis of 293 biologic treatment cycles from 198 patients (62 pediatric, 136 adult) across three academic centers.
- Psoriasis Area and Severity Index (PASI 90) response scores and drug survival (DS) times were analyzed.
Main Results:
- Efficacy (PASI 90) and drug survival rates were comparable between pediatric and adult patients for most biologics, with no statistically significant differences.
- Etanercept showed the longest mean drug survival in pediatric patients, but overall drug survival was significantly shorter in children than adults (30.58 vs. 72.34 months).
- Adalimumab demonstrated the longest mean drug survival in adults (101.28 months). All treatments exhibited favorable safety profiles, with no severe adverse events reported in pediatric patients.
Conclusions:
- Biologic treatments for psoriasis demonstrate comparable efficacy and safety profiles in pediatric and adult populations.
- While drug survival for etanercept was shorter in pediatric patients, overall safety signals did not limit the long-term use of these agents in children.
- Further research may explore factors contributing to differential drug survival rates in pediatric psoriasis patients.
Background:
Evidence on the effectiveness, long-term safety and longevity of biologic therapies in pediatric psoriasis patients is sparse.
Objective:
This study aims to compares the efficacy, safety and drug survival (DS) rates of etanercept (ETA), adalimumab (ADA), infliximab (INF), ustekinumab (UST), secukinumab (SEC) and ixekizumab (IXE) in pediatric and adult psoriasis patients.
Methods:
293 biologic treatment cycles of 198 patients (62 pediatric and 136 adult) from three academic psoriasis referral centres were analysed.
Results:
The following were the Psoriasis Area and Severity Index 90 response scores of pediatric and adult psoriasis patients, respectively: ETA, 42.3% vs. 34.6%; ADA, 53.8% vs. 59.8%; INF, 33.3% vs. 33.3%; UST, 76.5% vs. 56.8%; SEC, 60% vs. 60%; and IXE, 50% vs. 87.5%. The differences of responses between the two groups were statistically insignificant (p>0.05). ETA had the longest mean DS time in the pediatric group but it was related to a significantly shorter DS in pediatric patients than in adults (pediatrics: 30.58 [18.64-42.52] months vs. adults: 72.34 [54.70-89.99] months; p=0.025). ADA had the longest mean DS time in the adult group with 101.28 [84.88-117.68] months. All treatments had favorable safety profiles. No specific severe adverse effects necessitating treatment discontinuation were observed in pediatric patients.
Conclusion:
Although responses to ETA and UST were numerically better among children, the difference was insignificant. The DS rates in each group were comparable, and no specific safety signals, limiting the long-term use of these agents, were detected in the pediatric group.
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