Real-world data on the clinical use of secukinumab in pediatric generalized pustular psoriasis: A 48-week retrospective study

Ruan, Shifan; Zhang, Liangliang; Liu, Zhuo; Lin, Tingting; Wang, Haiqing; Xu, Qiuyun; Niu, Xiang; Cheng, Bo; Liu, Tao; Ha, Herena Y.; Gong, Ting; Ji, Chao

doi:10.1016/j.jaad.2022.04.064

Cited by 15 publications

(14 citation statements)

References 3 publications

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“…In recent years, biologic agents targeting TNF-α, IL-1, IL-12/23p40, IL-17A, and IL-36 have been reported in the treatment of GPP ( 5 , 6 ). Designed to target and neutralize IL-17A, secukinumab, a human monoclonal antibody, was evaluated for the treatment of GPP in a Phase III clinical study in Japan ( 7 ), and there are many real-world studies on pustular psoriasis in children ( 8 , 9 ). Due to the patient’s lack of response to standard therapy, the patient was given secukinumab for a total of 3 months.…”

Section: Discussionmentioning

confidence: 99%

Case report: Successful treatment of acute generalized pustular psoriasis of puerperium with secukinumab

et al. 2022

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Generalized pustular psoriasis (GPP) is a rare and severe form of psoriasis presenting with erythematous, aseptic pustules. Common systemic symptoms include fever and myalgias. The presentation of GPP resembles acute generalized exanthematous pustulosis (AGEP). However, the treatment of these two pathologies differs. While AGEP is self-limiting and treated with topical corticosteroids and constrain of systemic steroids. GPP treatment avoids corticosteroid, choosing acitretin, methotrexate, and cyclosporine as first-line agents. In this case report, a 27-year-old female with a medical history of AGEP presented to the hospital with extensive erythema and pustules. Complete blood count acute phase reactant analysis revealed an elevated white blood cell count and C-reactive protein (CRP). Two histopathological examinations revealed psoriatic hyperplasia of the epidermis with keratosis, along with Kogoj and Munro micro abscesses above the spina layer. Lymphocytic and neutrophilic infiltrate was present in the superficial derma layer along with vasodilation. The patient was diagnosed with GPP according to pathological and clinical criteria. Treatment was initiated with secukinumab because of the patient’s failure to respond to systemic treatment with Acitretin, methotrexate, and cyclosporin. Following 2 weeks of therapy with 300 mg of secukinumab, the pustular lesions had resolved. This study indicates the potential efficacy of secukinumab as an effective therapy that can rapidly improve the clinical symptoms of GPP.

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Section: Discussionmentioning

confidence: 99%

Case report: Successful treatment of acute generalized pustular psoriasis of puerperium with secukinumab

et al. 2022

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“…[29][30] A recent real-world study of Chinese children with GPP showed that secukinumab had an excellent therapeutic effect and lasted for up to 48 weeks. 31 In the phase III study by Imafuku et al,all patients (n = 12) developed AEs, the most common of which were nasopharyngitis, urticaria, diabetes mellitus, and arthralgia; additionally; 3 patients developed serious AEs, including Bowen disease and cellulitis, drug-induced liver injury, upper gastrointestinal hemorrhage, hypoglycemia, and abnormal hepatic function. 29 A systematic evaluation showed that the mean duration of treatment with biologic therapy against TNF-α (n = 55) and IL-17 (n = 32) was 9.3 and 12.7 months, with 58.1% (n = 55) and 66.7% (n = 32) achieving a complete response and 27.9% (n = 55) and 23.3% (n = 50) achieving a partial response, respectively.…”

Section: Parametersmentioning

confidence: 99%

Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Li¹,

Peng²,

Geng³

2022

International Journal of Dermatology and Venereology

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Objective: This study was performed to investigate the clinical characteristics of patients with generalized pustular psoriasis (GPP) in Northwest China. Methods: The clinical data of patients with GPP were retrospectively collected in the Second Affiliated Hospital of Xi’an Jiaotong University from January 1, 2017, to December 31, 2021 and analyzed using the chi-square test and Mann-Whitney U test. Results: In total, 179 hospitalized patients were included. The male:female ratio was 1.16:1.00, and the mean age at onset was 35.05 ± 19.11 years. Psoriasis vulgaris was also present in 76.0% of patients, and a family history of psoriasis was present in 15.6%. The mean duration of hospitalization was 10.67 ± 4.31 days, and the mean duration of flares was 29.58 ± 24.32 days. Infections and suspected drugs were predisposing factors. A fever developed in 54.7% of patients, and pruritus developed in 70.9%. Some patients had involvement of the nails (38.0%), scalp (46.9%), and tongue (4.5%). Cardiovascular disease, hypertension, and gallbladder-related disease were common comorbidities. The efficacy of acitretin was 84.7%, that of methotrexate was 66.7%, and that of cyclosporine was 100%. Fifteen patients were treated with secukinumab or adalimumab and responded well. The mean response time was 6.34 ± 2.91 days based on the combination treatments. The mean duration of the treatment regimen was 111.35 ± 94.25 days, and approximately 46.6% (n = 131) of patients developed recurrence. Conclusion: Our retrospective study showed that most cases of GPP were accompanied by psoriasis vulgaris and associated with fever or pruritus. Acitretin had good therapeutic efficacy, but recurrence should be noted. Biologics are increasingly becoming effective treatments, but their superiority and safety need further research.

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“…Patients with an insufficient outcome with conventional treatment (oral acitretin, cyclosporin) received secukinumab injections with clearance of skin lesions in up to 50% of baseline findings within 48 hours. In January 2023 Ruan et al 60 published a retrospective analysis of 18 children with general pustular psoriasis treated with secukinumab with a 48 weeks observation period. Secukinumab was used at a dose of 75 mg at weeks 0, 1, 2, 4 and every 4 weeks thereafter.…”

Section: Psoriasis and Pediatric Psoriasis - Introductionmentioning

confidence: 99%

Secukinumab for the Treatment of Psoriasis in Pediatrics: Patient Selection and Acceptability

Niedźwiedź¹,

Lesiak²,

Ceryn³

et al. 2023

PPA

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Psoriasis (PsO) is a chronic, systemic, immune-mediated inflammatory skin disease affecting 1% to 5% population worldwide. In one-third of patients, the first symptoms of PsO manifest in childhood, with a mean age of nine years. Psoriasis in children under 16 years of age constitutes 4% of dermatological problems in this age group. Chronic inflammation of the skin observed in PsO is associated with a development of potentially serious comorbidities, including psoriatic arthritis, hypertension, metabolic syndrome, cardiovascular diseases, inflammatory bowel disease, depression and anxiety. It is reported that among children with psoriasis between 5 and 16 years of age health-related quality of life is reduced by 30.5%. Early diagnosis and effective treatment are crucial in pediatric psoriatic patients to avoid future complications and stigmatization. Treatment for psoriasis consists of a range of topical medications, phototherapy and non-biologic and biologic systemic therapies. Approved biologics for PsO in pediatric patients include etanercept, adalimumab, ustekinumab, ixekizumab and secukinumab. Secukinumab, a recombinant, fully human monoclonal antibody targeting IL-17A, was approved by the EMA (2020) and FDA (2021) in pediatric patients above 6 years of age for the treatment of moderate to severe plaque psoriasis who are candidates for systemic therapy. This review discusses the selection and acceptability of secukinumab in children with psoriasis.

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Real-world data on the clinical use of secukinumab in pediatric generalized pustular psoriasis: A 48-week retrospective study

Cited by 15 publications

References 3 publications

Case report: Successful treatment of acute generalized pustular psoriasis of puerperium with secukinumab

Case report: Successful treatment of acute generalized pustular psoriasis of puerperium with secukinumab

Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Secukinumab for the Treatment of Psoriasis in Pediatrics: Patient Selection and Acceptability

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