Management of pediatric plaque psoriasis using biologics.


Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 03 12 2018
revised: 21 05 2019
accepted: 23 05 2019
pubmed: 1 6 2019
medline: 1 7 2020
entrez: 1 6 2019
Statut: ppublish

Résumé

Psoriasis is a chronic inflammatory disease with clinical manifestations of the skin that affect adults and children. In adults, biologics have revolutionized the treatment of moderate to severe plaque psoriasis where clear or almost clear is a tangible goal. Research on biologics has recently been extended to children. The introduction of these new therapeutic options has outpaced the limited guidelines in this population. To provide a review of current data on biologics, with a proposal for a clinically relevant treatment algorithm on the management of moderate to severe plaque psoriasis in the pediatric population. A Canadian panel with expertise in psoriasis, pediatric dermatology, and experience with consensus recommendation processes was selected to review the current landscape of pediatric psoriasis and clinical data on biologics plus identify special considerations for baseline workup and monitoring. Recommendations were reviewed and edited by each expert in an iterative process. A treatment algorithm for moderate to severe plaque psoriasis in pediatric patients is presented, incorporating approved biologics. Guidance on baseline screening and ongoing monitoring is also provided. Ultimately, treatment choice depends on the patient and his or her caregiver, with consideration of comorbidities, impact on quality of life, and relevant safety aspects.

Sections du résumé

BACKGROUND BACKGROUND
Psoriasis is a chronic inflammatory disease with clinical manifestations of the skin that affect adults and children. In adults, biologics have revolutionized the treatment of moderate to severe plaque psoriasis where clear or almost clear is a tangible goal. Research on biologics has recently been extended to children. The introduction of these new therapeutic options has outpaced the limited guidelines in this population.
OBJECTIVE OBJECTIVE
To provide a review of current data on biologics, with a proposal for a clinically relevant treatment algorithm on the management of moderate to severe plaque psoriasis in the pediatric population.
METHODS METHODS
A Canadian panel with expertise in psoriasis, pediatric dermatology, and experience with consensus recommendation processes was selected to review the current landscape of pediatric psoriasis and clinical data on biologics plus identify special considerations for baseline workup and monitoring. Recommendations were reviewed and edited by each expert in an iterative process.
CONCLUSION CONCLUSIONS
A treatment algorithm for moderate to severe plaque psoriasis in pediatric patients is presented, incorporating approved biologics. Guidance on baseline screening and ongoing monitoring is also provided. Ultimately, treatment choice depends on the patient and his or her caregiver, with consideration of comorbidities, impact on quality of life, and relevant safety aspects.

Identifiants

pubmed: 31150699
pii: S0190-9622(19)30860-6
doi: 10.1016/j.jaad.2019.05.056
pii:
doi:

Substances chimiques

Biological Products 0
Dermatologic Agents 0
Interleukin-23 0
Tumor Necrosis Factor-alpha 0
Interleukin-12 187348-17-0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

213-221

Informations de copyright

Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Perla Lansang (P)

Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. Electronic address: perlalansang@gmail.com.

James N Bergman (JN)

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.

Loretta Fiorillo (L)

Division of Pediatric Dermatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

Marissa Joseph (M)

Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

Irene Lara-Corrales (I)

Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

Danielle Marcoux (D)

Division of Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada.

Catherine McCuaig (C)

Division of Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada.

Elena Pope (E)

Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

Vimal H Prajapati (VH)

Division of Dermatology, Department of Medicine, and Divisions of Community Pediatrics and Pediatric Rheumatology, Department of Pediatrics, University of Calgary; and Dermatology Research Institute, Calgary, Alberta, Canada.

Sue Z J Li (SZJ)

Janssen Inc, Toronto, Ontario, Canada.

Ian Landells (I)

Memorial University of Newfoundland and Nexus Clinical Research, St John's, Newfoundland, Canada.

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Classifications MeSH