The Role of Biologics and Other Systemic Agents in the Treatment of Pediatric Psoriasis

Wright, Natalie; Piggott, Caroline; Eichenfield, Lawrence F.

doi:10.1016/j.sder.2010.01.003

Cited by 19 publications

(38 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, it is recommended that patients take folic acid 5 mg PO 24 hours after the MTX dose . Once there is a sufficient treatment response, the absolute weekly dose may be slowly tapered, for instance, by 2.5 mg every 2–3 months .…”

Section: Treatmentmentioning

confidence: 99%

S2k guidelines for the treatment of psoriasis in children and adolescents – Short version part 2

Eisert

Augustin

Bach

et al. 2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

Summary The present guidelines are aimed at residents and board‐certified physicians in the fields of dermatology, pediatrics, pediatric dermatology and pediatric rheumatology as well as policymakers and insurance funds. They were developed by dermatologists and pediatric dermatologists in collaboration with pediatric rheumatologists using a formal consensus process (S2k). The guidelines highlight topics such as disease severity, quality of life, treatment goals as well as problems associated with off‐label drug therapy in children. Trigger factors and diagnostic aspects are discussed. The primary focus is on the various topical, systemic and UV‐based treatment options available and includes recommendations for use and treatment algorithms. Other aspects addressed herein include vaccinations in children and adolescents with psoriasis as well as various disease subtypes such as guttate psoriasis, diaper psoriasis, pustular psoriasis and psoriatic arthritis. Finally, we also provide recommendations for imaging studies and the diagnostic workup to rule out tuberculosis prior to initiating systemic treatment. Note: This article constitutes part 2 of the Sk2 guidelines for the treatment of psoriasis in children and adolescents. Part 1 was published in last month's issue. It contained introductory remarks and addressed aspects of diagnosis and topical treatment.

show abstract

Section: Treatmentmentioning

confidence: 99%

S2k guidelines for the treatment of psoriasis in children and adolescents – Short version part 2

Eisert

Augustin

Bach

et al. 2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

show abstract

“…Aufgrund der langjährigen klinischen Erfahrungen hinsichtlich Systemtherapie, Medikamentennebenwirkungen und Medikamentensicherheit bei der Anwendung im Kindesalter wird MTX als First‐Line‐Therapie für die systemische Behandlung der mittelschweren bis schweren Plaque‐Psoriasis im Kindesalter (analog zur Beurteilung der Therapie im Erwachsenenalter) gesehen . Aufgrund der fehlenden Indikationszulassung im Kindesalter ist die Therapie jedoch off‐label und mit Medikamenten wie Adalimumab stehen im Kindesalter ab vier Jahren mögliche In‐Label‐Therapien zur Verfügung .…”

Section: Therapieunclassified

S2k‐Leitlinie zur Therapie der Psoriasis bei Kindern und Jugendlichen – Kurzfassung Teil 2

Eisert

Augustin

Bach

et al. 2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

Zusammenfassung Diese Leitlinie richtet sich an Assistenz‐ und Fachärzte der Dermatologie, Pädiatrie, Kinderdermatologie und Kinderrheumatologie sowie an Kostenträger und politische Entscheidungsgremien. Die Leitlinie wurde im formellen Konsensusverfahren (S2k) von Dermatologen und Kinderdermatologen unter Einbindung von Kinderrheumatologen erstellt. Die Leitlinie stellt einen Überblick über Schweregrad, Lebensqualität und Therapieziele mit Erläuterung der Off‐Label‐Problematik im Kindesalter dar. Es werden Diagnosestellung und Triggerfaktoren erläutert. Der Schwerpunkt der Leitlinie liegt auf der Darstellung der verschiedenen topischen Therapien, UV‐Therapien und systemischen Therapieoptionen mit Abbildung der Empfehlungen zur Anwendung der Therapien sowie Therapiealgorithmen. Darüber hinaus wird im Kontext auf Impfungen bei Psoriasis im Kindesalter sowie auf verschiedene Sonderformen wie Psoriasis guttata, Windelpsoriasis, Psoriasis pustulosa und Psoriasisarthritis eingegangen. Auch werden Empfehlungen zu Tuberkulosediagnostik und Röntgenuntersuchung vor Systemtherapie gegeben.

show abstract

“…Methotrexate is a folic acid analog that reversibly inhibits dihydrofolate reductase, thus interfering with deoxyribonucleic acid synthesis and repair and replication of T and B lymphocytes 41. It has been used in the treatment of psoriasis since the 1950s 36.…”

Section: Management Of Psoriasis In Adolescencementioning

confidence: 99%

“…However, according to published case series and reports, as well as expert consensus, methotrexate can be used successfully for the treatment of recalcitrant plaque, erythrodermic and pustular psoriasis, or even pso-riatic arthritis 42–45. Doses of methotrexate for adolescents range between 0.2 and 0.7 mg/kg 36,41. An initial dose of 1.25–5 mg/week should be administered, ideally at the beginning of treatment, with 1-week laboratory follow-up to monitor for toxicity 36,41.…”

Section: Management Of Psoriasis In Adolescencementioning

confidence: 99%

“…Doses of methotrexate for adolescents range between 0.2 and 0.7 mg/kg 36,41. An initial dose of 1.25–5 mg/week should be administered, ideally at the beginning of treatment, with 1-week laboratory follow-up to monitor for toxicity 36,41. If it is well tolerated, then methotrexate dosage can be increased until therapeutic control is achieved.…”

Section: Management Of Psoriasis In Adolescencementioning

confidence: 99%

See 1 more Smart Citation

Management of psoriasis in adolescence

Fotiadou¹,

Lazaridou²,

Ioannides³

2014

AHMT

View full text Add to dashboard Cite

Psoriasis is a chronic inflammatory cutaneous disorder affecting 2%–4% of the world’s population. The prevalence of the disease in childhood and adolescence ranges between 0.5% and 2%. The management of psoriasis in adolescence is an intriguing and complicated task. Given the paucity of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, physicians must rely on published experience from case reports both from the field of dermatology as well as from the application of these drugs for other pediatric conditions coming from the disciplines of rheumatology, gastroenterology, and oncology. Psoriatic adolescents deal with a potentially disfiguring and lifelong disease that could permanently impair their psychological development. It must be clarified to them that psoriasis does not have a permanent cure, and therefore the main goal of treatments is to establish disease control and prolonged periods between flares. The majority of adolescents suffer from mild psoriasis, and thus they are treated basically with topical treatment modalities. Phototherapy is reserved for adolescents with mild-to-moderate plaque disease and/or guttate psoriasis when routine visits to specialized centers do not create practical problems. Systemic agents and biologics are administered to patients with moderate-to-severe plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis.

show abstract

The Role of Biologics and Other Systemic Agents in the Treatment of Pediatric Psoriasis

Cited by 19 publications

References 42 publications

S2k guidelines for the treatment of psoriasis in children and adolescents – Short version part 2

S2k guidelines for the treatment of psoriasis in children and adolescents – Short version part 2

S2k‐Leitlinie zur Therapie der Psoriasis bei Kindern und Jugendlichen – Kurzfassung Teil 2

Management of psoriasis in adolescence

Contact Info

Product

Resources

About