Anti-TNF agents for paediatric psoriasis

Sanclemente, Gloria; Murphy, Ruth; Contreras, Javier; Rengifo‐Pardo, Mónica; García, Hermenegildo; Cosp, Xavier Bonfill

doi:10.1002/14651858.cd010017

Cited by 13 publications

(14 citation statements)

References 31 publications

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“…Etanercept has been shown to be well tolerated and effective in moderate-to-severe cases of plaque psoriasis [ 15 , 26 - 27 ] through 96 weeks of treatment [ 26 ], and through 60 months of treatment in pediatric GPP [ 14 ]. Hawrot, et al reported on nine severe recalcitrant pediatric psoriasis patients who received etanercept; seven experienced sustained improvement of their symptoms, and three had complete clearance within three months [ 16 ].…”

Section: Reviewmentioning

confidence: 99%

Biologics and Pediatric Generalized Pustular Psoriasis: An Emerging Therapeutic Trend

Saikaly¹,

Mattes²

2016

Cureus

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Generalized pustular psoriasis (GPP) is a rare form of childhood psoriasis, often requiring systemic therapy, which is challenging as there is a paucity of randomized controlled trials and standardized guidelines. Biologic agents have been used in adults and in pediatric plaque psoriasis, but evidence regarding their efficacy in pediatric GPP has slowly become available. The objective of this study is to summarize and compare the efficacy and safety of biologic agents, such as etanercept, infliximab, and adalimumab, in the treatment of pediatric GPP. A PubMed literature review was conducted and 12 studies met the inclusion criteria for analysis. After reviewing the efficacy of these drugs in pediatric GPP patients and their safety in the use of other pediatric conditions, etanercept was identified as a possible first-line biologic agent for pediatric psoriasis, including GPP, followed by infliximab and adalimumab. In conclusion, several case reports have documented the successful use of biologic agents in refractory cases of pediatric GPP, but clinical trials are needed to gain a better understanding of the efficacy and side effect profile in this population.

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Section: Reviewmentioning

confidence: 99%

Biologics and Pediatric Generalized Pustular Psoriasis: An Emerging Therapeutic Trend

Saikaly¹,

Mattes²

2016

Cureus

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“…Apart from a dearth of meta‐analyses and reviews on IFIs associated with the use of TNFα inhibitors among children and adolescents, a considerable number of studies on pediatric patient populations receiving TNFα inhibitors reported no IFIs …”

Section: Risk For Invasive Fungal Infections In Childrenmentioning

confidence: 99%

Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF‐α) inhibitors

Tragiannidis

Kyriakidis

Zündorf

et al. 2016

Mycoses

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Macromolecular immunosuppressive monoclonal antibodies and fusion proteins directed against molecules or cells involved in inflammation and immunity represent a recent and important addition to our therapeutic armamentarium. Tumor necrosis alpha (TNFα) is a cytokine involved in systemic inflammation and clinical utilization of its antagonists has revolutionized treatment of juvenile rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and plaque psoriasis. Clinical utility has also been demonstrated for use against steroid-refractory graft-vs-host disease and other immune-mediated conditions. Currently, five anti-TNFα agents are approved by the European Medicines Agency (EMA), including the monoclonal anti-TNF antibodies infliximab, adalimumab, golimumab and certolizumab pegol along with etanercept, a TNFα-receptor/IgG-Fc fusion protein. Theoretical considerations related to their mode of action and clinical observations suggest that opportunistic infectious complications should be seriously considered as possible adverse events of macromolecular immunosuppressants. The purpose of this review is to critically analyze the literature on invasive fungal infections (IFIs) occurring in association with TNFα inhibitors alone or in combination with other immunosuppressive agents, with a focus on pediatric patients, and to provide a framework of evaluating the risk for IFIs in this population.

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“…A Cochrane SR of the efficacy and safety of TNFI agents for paediatric psoriasis found only one 12‐week randomized, double‐blind, placebo‐controlled trial of etanercept use in patients (age range 4–17 years, median 13 years) with severe psoriasis suitable for inclusion . At week 12, PASI75 was reached by 57% of participants taking etanercept versus 11% receiving placebo [risk ratio (RR) = 4.95, CI 2.83–8.65] with an increase in non‐SAEs.…”

Section: Biologic Therapiesmentioning

confidence: 99%

What's new in psoriasis treatment? An analysis of systematic reviews published in 2015

et al. 2018

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This review provides a summary of key findings from 27 systematic reviews of 51 articles first published or indexed during 2015, focusing on the treatment of psoriasis and on precision medicine in psoriasis. The evidence supports weight-loss interventions by dieting and exercise for improvement in disease severity in overweight and obese patients with psoriasis. No significant increased risk of serious infections was reported for the biologic therapies adalimumab, etanercept and ustekinumab compared with appropriate comparators. Evidence could not provide reliable estimates of rare adverse events, emphasizing the need for large prospective registries. Polymorphisms in the tumour necrosis factor (TNF)-α gene may confer improved responses to TNF inhibitor (TNFI) therapy, but the studies to date lack power to detect a true association. From the limited available evidence, multidisciplinary management is both more effective and more satisfactory for patients with psoriasis and psoriatic arthritis than conventional consultations. This summary of reviews provides a succinct guide for clinicians and patients wishing to remain up to date with high-quality evidence for the treatment of psoriasis.

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Anti-TNF agents for paediatric psoriasis

Cited by 13 publications

References 31 publications

Biologics and Pediatric Generalized Pustular Psoriasis: An Emerging Therapeutic Trend

Biologics and Pediatric Generalized Pustular Psoriasis: An Emerging Therapeutic Trend

Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF‐α) inhibitors

What's new in psoriasis treatment? An analysis of systematic reviews published in 2015

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