Successful secukinumab treatment of recalcitrant juvenile generalized pustular psoriasis

Nishida, Marina; Takeichi, Takuya; Kono, Michihiro; Imanishi, Akiko; Maekawa, Naoki; Akiyama, Masashi; Fukai, Kazuyoshi

doi:10.1111/1346-8138.15228

Cited by 8 publications

(9 citation statements)

References 5 publications

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“…3,4 Six of these eight children had previously failed conventional systemic therapy, five had known IL36RN mutations, three were treated with secukinumab monotherapy, and all eight patients experienced rapid and sustained improvement, without adverse events. [1][2][3][4][5] In June 2021, secukinumab received FDA approval for use for pediatric psoriasis in children down to age 6 years. Our case lends further support for safety and efficacy in even younger children.…”

Section: Discussionmentioning

confidence: 99%

“…Generalized pustular psoriasis is a rare and severe form of psoriasis that is characterized by recurrent episodes of diffuse cutaneous erythema covered with pinpoint pustules and generally accompanied by fever, general malaise, and elevated inflammatory markers. 1 GPP without a history of plaque psoriasis has been reported in association with IL36RN mutations. 2 The treatment of pediatric GPP can be challenging as it may be refractory to conventional systemic therapies such as acitretin, cyclosporine, and methotrexate.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of secukinumab in pediatric GPP is more limited, but five studies involving a total of eight patients have reported successful use 3,4 . Six of these eight children had previously failed conventional systemic therapy, five had known IL36RN mutations, three were treated with secukinumab monotherapy, and all eight patients experienced rapid and sustained improvement, without adverse events 1‐5 …”

Section: Discussionmentioning

confidence: 99%

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Successful treatment of a 3‐year‐old girl with generalized pustular psoriasis using secukinumab monotherapy

Zhu

Song

et al. 2021

Pediatric Dermatology

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We report a case of a 3-year-old girl with generalized pustular psoriasis (GPP) and a compound heterozygous mutation within the IL36 receptor antagonist (IL36RN) gene at c.28C>T and c.115+6T>C, who was successfully treated using secukinumab monotherapy. The first dose of secukinumab (150 mg) was administered subcutaneously, followed by 75 mg of secukinumab subcutaneously once weekly for 4 weeks and then 75 mg every 4 weeks. The total course of treatment was 4 months, with a total of 8 doses. A PASI score of 75 and 100 was achieved at weeks 1 and 2, respectively, and maintained for 11 months of follow-up, without disease recurrence or adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Successful treatment of a 3‐year‐old girl with generalized pustular psoriasis using secukinumab monotherapy

Zhu

Song

et al. 2021

Pediatric Dermatology

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“…While there are several biologic agents available for the treatment of GPP in Japan, more robust data is needed to optimize the use of these agents in all patient types. Table 4 summarizes available evidence for the use of systemic treatments for GPP in different patient groups [1,[66][67][68][69][70][71][72][73][74][75][76]. To date, the approval of antagonists of IL-17 and IL-23 has been based on clinical trials that included mostly cases of moderate disease, so there is not adequate evidence to fully understand how these agents perform against GPP flares.…”

Section: Special Populations and Unmet Needsmentioning

confidence: 99%

“…However, there is a relative lack of safety data in children, so the advantages of using biologic agents must be balanced with caution. There is a growing number of case reports describing the successful treatment of children with infliximab, adalimumab, and secukinumab [52,71,72]. GL C1 [1] ≥1 OCT [1] Unlikely to be used…”

Section: Pediatric Patientsmentioning

confidence: 99%

Generalized pustular psoriasis: current management status and unmet medical needs in Japan

Komine

Morita

2021

Expert Review of Clinical Immunology

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Introduction: Generalized pustular psoriasis (GPP) is a rare, inflammatory skin disease characterized by recurrent flares of pustulation accompanied by systemic symptoms that can be life-threatening. The clinical and humanistic burden of GPP in Japan is high, and it is a designated intractable disease. We reviewed clinical evidence and guidelines for GPP treatment in Japan to identify unmet needs and assess data supporting the development and use of new targeted therapies. Areas covered: Using specific search terms in PubMed and Embase, with additional back-referencing, we retrieved literature related to GPP in Japan focusing on clinical and pathogenic characteristics, diagnosis, and treatment. Expert opinion: Although there are approved systemic therapies for GPP in Japan, all present uncertainties in terms of safety and efficacy. Clinical evidence supporting their use comes mostly from studies in patients with mild or moderate disease, and their effectiveness in treating acute phase GPP is unknown. The interleukin-36 pathway appears to be central to GPP pathogenesis. New therapies targeting this pathway show promise in patients presenting with acute phase GPP. The rarity and intermittent course of GPP make it challenging to recruit sufficient patients for trials and robustly investigate the efficacy and safety of these agents to treat GPP.

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The update of treatment strategies in pediatrics with generalized pustular psoriasis in China

Chen,

Xiang,

Wang

et al. 2023

Pediatric Investigation

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Generalized pustular psoriasis (GPP) is a severe subtype of psoriasis, commonly combined with systemic inflammation. Gene mutations have been found to be associated with GPP and vary by ethnicity. Systemic treatments are usually required for the severity and potential complications of GPP. However, there is no common consensus in China, especially among pediatric patients, whose data are scarce. Acitretin, methotrexate, and cyclosporine are widely used in pediatrics with GPP, while the adverse effects should be highlighted. The emergence of different biological agents brings us into a new era. This article discusses the genetic background of Chinese patients and demonstrates the evidence of treatment in pediatrics with GPP.

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Successful secukinumab treatment of recalcitrant juvenile generalized pustular psoriasis

Cited by 8 publications

References 5 publications

Successful treatment of a 3‐year‐old girl with generalized pustular psoriasis using secukinumab monotherapy

Successful treatment of a 3‐year‐old girl with generalized pustular psoriasis using secukinumab monotherapy

Generalized pustular psoriasis: current management status and unmet medical needs in Japan

The update of treatment strategies in pediatrics with generalized pustular psoriasis in China

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