Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis in pediatric patients

Menter, Alan; Cordoro, Kelly M.; Davis, Dawn M.; Kroshinsky, Daniela; Paller, Amy S.; Armstrong, April W.; Connor, Cody; Elewski, Boni E.; Gelfand, Joel M.; Gordon, Kenneth B.; Gottlieb, Alice B.; Kaplan, Daniel H.; Kavanaugh, Arthur; Kiselica, Matthew; Kivelevitch, Darío; Korman, Neil J.; Lebwohl, Mark; Leonardi, Craig L.; Lichten, Jason; Lim, Henry W.; Mehta, Nehal N.; Parra, Sylvia L.; Pathy, Arun L.; Prater, Elizabeth A. Farley; Rupani, Reena; Siegel, Michael; Stoff, Benjamin K.; Strober, Bruce; Wong, Emily; Wu, Jashin J.; Hariharan, Vidhya; Elmets, Craig A.

doi:10.1016/j.jaad.2019.08.049

Cited by 158 publications

(255 citation statements)

References 147 publications

(253 reference statements)

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“…As there have been few clinical studies of paediatric psoriasis, treatment options are limited and often used off‐label. Topical therapies comprise first‐line treatment, followed by phototherapy for moderate‐to‐severe paediatric psoriasis . Systemic treatments are recommended for moderate‐to‐severe paediatric psoriasis recalcitrant to topical therapies .…”

mentioning

confidence: 99%

“…Topical therapies comprise first‐line treatment, followed by phototherapy for moderate‐to‐severe paediatric psoriasis . Systemic treatments are recommended for moderate‐to‐severe paediatric psoriasis recalcitrant to topical therapies . Nonbiologic systemic treatments such as methotrexate or ciclosporin are used, but they may not be well tolerated or provide adequate efficacy …”

mentioning

confidence: 99%

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Efficacy and safety of ixekizumab in a phase III , randomized, double‐blind, placebo‐controlled study in paediatric patients with moderate‐to‐severe plaque psoriasis ( IXORA ‐ PEDS )

Paller

Seyger

Magariños³

et al. 2020

Br J Dermatol

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Summary Background Plaque psoriasis affects children and adults, but treatment options for paediatric psoriasis are limited. Objectives To evaluate the efficacy and safety of ixekizumab (IXE), a high‐affinity monoclonal antibody that selectively targets interleukin‐17A, for moderate‐to‐severe paediatric psoriasis. Methods In a randomized, double‐blind, placebo‐controlled, phase III study (IXORA‐PEDS), patients aged 6 to < 18 years with moderate‐to‐severe plaque psoriasis were randomized 2 : 1 to weight‐based dosing of IXE every 4 weeks (IXE Q4W, n = 115) or placebo (n = 56) through week 12, followed by open‐label IXE Q4W. Coprimary endpoints were the proportions of patients at week 12 achieving ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) and those achieving a static Physician's Global Assessment score of 0 or 1 (sPGA 0,1). Results IXE was superior (P < 0·001) to placebo for both coprimary endpoints of PASI 75 (IXE Q4W, 89%; placebo, 25%) and sPGA (0,1) (IXE Q4W, 81%; placebo, 11%). IXE was also superior for all gated secondary endpoints, including PASI 75 and sPGA (0,1) at week 4, improvement in itch, and complete skin clearance. IXE Q4W provided significant (P < 0·001) improvements vs. placebo in quality of life and clearance of scalp and genital psoriasis. Responses at week 12 were sustained or further improved through week 48. Through week 12, 45% (placebo) and 56% (IXE) of patients reported treatment‐emergent adverse events. One serious adverse event was reported (IXE), one patient discontinued due to an adverse event (placebo) and no deaths were reported. Conclusions IXE was superior to placebo in the treatment of moderate‐to‐severe paediatric psoriasis, and the safety profile was generally consistent with that observed in adults. What is already known about this topic? Paediatric psoriasis affects approximately 1% of children and can negatively impact health‐related quality of life. Treatment options for paediatric psoriasis are typically limited to off‐label treatments and approved systemic biologics. Ixekizumab, a high‐affinity monoclonal antibody that selectively targets interleukin‐17A, is approved for moderate‐to‐severe plaque psoriasis in adults and was recently approved by the US Food and Drug Administration for moderate‐to‐severe paediatric psoriasis. What does this study add? Ixekizumab resulted in rapid and statistically significant improvements over placebo in skin involvement, itch and health‐related quality of life, which persisted through 48 weeks of treatment in paediatric patients with moderate‐to‐severe plaque psoriasis. The safety profile of ixekizumab was generally consistent with that seen in adults. Ixekizumab may be an additional potential therapeutic option and an additional class of biologic therapy (interleukin‐17A antagonist) for the treatment of moderate‐to‐severe paediatric psoriasis. Plain language summary available online

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confidence: 99%

mentioning

confidence: 99%

Efficacy and safety of ixekizumab in a phase III , randomized, double‐blind, placebo‐controlled study in paediatric patients with moderate‐to‐severe plaque psoriasis ( IXORA ‐ PEDS )

Paller

Seyger

Magariños³

et al. 2020

Br J Dermatol

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“…Once the severity of the disease is controlled, it is suggested to stop the systemic treatment. Above all, the rule of thumb is always to select a drug with fewer side effects if long-term therapy is required [13].…”

Section: Systemic Therapies: Biological Versus Non-biologicalmentioning

confidence: 99%

“…Treating the pediatric moderate to severe psoriatic population with biologics is a big challenge but as per the Joint American Academy of Dermatology-National Psoriasis Foundation (AAD-NPF) guideline: severity of illness, failure of other traditional treatments (topical and other systemic medication, phototherapy), compromised psychosocial quality of life, comorbidities mainly arthritis and types of psoriasis are the key indicators for selection of biologic treatment [13].…”

Section: Critical Approach Towards Biologicsmentioning

confidence: 99%

FDA Approved Biologics: Can Etanercept and Ustekinumab be Considered a First-Line Systemic Therapy for Pediatric/Adolescents in Moderate to Severe Psoriasis? A Systematic Review

Aslam

Saleem

Murtazaliev

et al. 2020

Cureus

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Psoriasis is a chronic immune-mediated skin disorder. Due to lack of clarity in its pathogenesis, a cure with existing treatment is a big challenge. Biologics, a revolutionary treatment, are potent immunomodulators that explicitly target the culprit cells of the immune system to achieve the maximum level of Psoriasis Area and Severity Index (PASI) score (75 to 90) and clear or almost clear skin in moderate to severe psoriasis. They have been a successful therapy in adult severe psoriasis for a decade.

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“…Водночас зі встановленням діагнозу постало питання тактики ведення пацієнта. Слід зазна чити, що псоріаз у нього виник на тлі прийому метотрексату, який розглядався і тепер розгля дається, як один зі стандартів лікування цієї недуги [18,24]. Очевидно, що мали рацію американські вчені з Чикаго (штат Іллінойс, США), охарактеризувавши коморбідність ЮДМ та псоріазу подвійною неприємністю, зазначивши при цьому виникаючі протиріччя у загальному та медикаментозному лікуванні цих двох захворювань [16].…”

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Debut and course rare of juvenile dermatomyositis. Part II: clinical analysis with comparative analytical review of the literature

Rеitmаier¹,

Volosyanko²,

Synoverska³

et al. 2020

MPU

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The first part of the article describes a rare case of the onset and course of juvenile dermatomyositis. In the second part the comparative clinical analysis of results of own supervision with other similar reports is carried out. The main attention is focused on atypical variants of the onset of the disease, in particular signs of severe intoxication syndrome, hemorrhagic-necrotic rash, anasarca, lesions of the oral cavity in the form of stomatitis and ulcerative-necrotic glossitis. The difficulties of early diagnosis of the disease on the background of delayed manifestation of pathognomonic skin signs and the absence of reliable features of myopathic syndrome are shown. Clinical and laboratory characteristics of amyopathic juvenile dermatomyositis with persistent skin lesions have been defined. There are three differentiated plans-recommendations of the Childhood Arthritis and Rheumatology Research Alliance for the treatment of patients who have never had muscle damage and those who have had clinical manifestations of myopathy only in the first months of the disease. Current trends in achievements and gaps in the classification, diagnosis and treatment of various forms of juvenile dermatomyositis have been observed. On the basis of scientific publications the possible prognostic consequences of the amyopathic form of this disease in children are highlighted. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: juvenile dermatomyositis, juvenile amyopathic dermatomyositis, atypical course, ulcerative necrotic glossitis, anasarca, psoriasis, treatment.

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Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis in pediatric patients

Cited by 158 publications

References 147 publications

Efficacy and safety of ixekizumab in a phase III , randomized, double‐blind, placebo‐controlled study in paediatric patients with moderate‐to‐severe plaque psoriasis ( IXORA ‐ PEDS )

Efficacy and safety of ixekizumab in a phase III , randomized, double‐blind, placebo‐controlled study in paediatric patients with moderate‐to‐severe plaque psoriasis ( IXORA ‐ PEDS )

FDA Approved Biologics: Can Etanercept and Ustekinumab be Considered a First-Line Systemic Therapy for Pediatric/Adolescents in Moderate to Severe Psoriasis? A Systematic Review

Debut and course rare of juvenile dermatomyositis. Part II: clinical analysis with comparative analytical review of the literature

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