Biological treatments for paediatric psoriasis : a retrospective observational study on biological drug survival in daily practice in childhood psoriasis

Phan, C.; Beauchet, Alain; Burztejn, Anne-Claire; Sévérino-Freire, Maëlla; Barbarot, S.; Girard, C.; Lasek, A.; Réguiai, Z.; Hadj‐Rabia, S.; Abasq, C.; Brenaut, E.; Droitcourt, Catherine; Perrussel, M.; Mallet, S.; Phan, Alice; Lacour, Jean‐Philippe; Khemis, A.; Bourrat, E.; Chaby, G.; DeBorde, Rozann; Plantin, P.; Maruani, Annabel; Piram, Maryam; Maccari, F.; Fougerousse, Anne‐Claire; Kupfer‐Bessaguet, I.; Balguérie, X.; Barthélémy, H.; Martin, Ludovic; Quiles‐Tsimaratos, N.; Mery-Brossard, L.; Pallure, V.; Lons‐Danic, D.; Bouilly-Auvray, D.; Beylot‐Barry, M.; Puzenat, E.; Aubin, F.; Mahé, E.

doi:10.1111/jdv.15579

Cited by 29 publications

(47 citation statements)

References 23 publications

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“…Recommendations from a pediatric dermatology expert panel suggested adalimumab as first line treatment in moderate to severe psoriasis of childhood according to its level of evidence "A" and EMA approval (Belloni Fortina et al, 2017). Phan et al found, in a real-life comparative study, that ustekinumab had the best drug survival outcome among the three biotherapies licensed in childhood psoriasis (Phan et al, 2019 to previously untreated patients. However, adalimumab proved to be effective in a high proportion of adult patients after a first-line anti-TNFα failure in a real life study (Esposito et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Adalimumab in severe plaque psoriasis of childhood: A multi‐center, retrospective real‐life study up to 52 weeks observation

Lernia

Bianchi

Guerriero

et al. 2019

Dermatologic Therapy

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The objective of this study is to determine drug effectiveness and safety of the tumor necrosis factor‐alpha blocker monoclonal antibody adalimumab in a real‐life cohort of 54 children and/or adolescents with severe plaque psoriasis. Retrospective, multicenter analysis over a 52‐week period is discussed in this study. Efficacy was determined by the percentage of patients achieving Psoriasis Area Severity Index (PASI 75) and PASI 90 at weeks 16, 24, and 52 and the response in biologic‐naïve versus non‐naïve patients. Safety was assessed by the number of patients experiencing at least one adverse event. At week 16, 29.6% of patients achieved a 90% PASI score reduction (PASI 90), while 55.5% of patients achieved a 75% PASI score reduction (PASI 75). Effectiveness was sustained through week 24, since PASI 90 response increased to 55.5% and PASI 75 response increased to 74.0% of patients. The PASI response rates did not differ between biologic‐naïve and non‐naïve patients. The drug was well tolerated and no serious infections were observed. Adalimumab was effective and safe in this cohort of children with severe plaque psoriasis in a 52‐week observation. Effectiveness did not differ between biologic‐naïve and non‐naïve patients.

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Section: Discussionmentioning

confidence: 99%

Adalimumab in severe plaque psoriasis of childhood: A multi‐center, retrospective real‐life study up to 52 weeks observation

Lernia

Bianchi

Guerriero

et al. 2019

Dermatologic Therapy

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“…В настоящее время расширение понимания происходящих патогенетических процессов, лежащих в основе заболевания, изучение таргетных механизмов воздействия, поиск алгоритмов, направленных на увеличение эффективности и длительности назначаемой пациенту биологической терапии, а также выявление значимых факторов риска, приводящих к отсутствию/снижению эффекта биологических препаратов, являются главными целями ведущих научных исследований в области изучения ГИБП. Поскольку имеющиеся ограниченные данные о выживаемости биологической терапии при псориазе у детей требуют подтверждения, а также недостаточно изучен характер оказываемого на данный показатель влияния различных внутренних и внешних факторов риска, то тема данной работы, по нашему мнению, является актуальной [8]. Также мы считаем, что результаты этого исследования в дальнейшем позволят расширить использование генно-инженерных биологических препаратов в педиатрической практике и задать стандарты назначения / алгоритмы выбора определенного ГИБП в качестве первой или последующей линии терапии в зависимости от конкретных индивидуальных особенностей пациента для своевременного достижения длительной ремиссии, тем самым позволяя перейти в новый век персонализированной медицины.…”

Section: обоснованиеunclassified

Biological Therapy Survivability in Children with Psoriasis: Cohort Study

Иванов

Мурашкин

2021

Vopr. sovr. pediatr.

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Background. There is a need to study genetically engineered biological therapy (GEBT) survivability and identify any significant risk factors for its ineffectiveness due to the increasing prevalence of psoriasis among children and the spreading GEBT administration. Such information has practical importance, it can be used to predict treatment outcomes and to develop individual therapeutic approaches. Objective. Our aim was to study biological therapy survivability and to identify risk factors for its ineffectiveness in children with moderate and severe forms of psoriasis. Methods. The study included data from 4-17 years old patients with moderate and severe forms of psoriasis vulgaris. Groups were formed according to the biological medication used. Statistical analyses were performed via SPSS Statistics. Biologic therapy survivability was determined via Kaplan-Meier method with the assessment of differences significance using log-rank test. Significant factors affecting cumulative risk growth were determined by Cox multiple regression method. Results. The study analysed data from the medical records of 105 patients. The average survivability of ustekinumab was 28.7 months, etanercept — 23.1, and adalimumab — 18.4. In the group of bio-naive patients, the survivability was higher: 30.8 months for ustekinumab and 24.4 months for ethanercept, while in the group of patients administrated previously with biological medication the survivability was 24.2 and 8.3 months, respectively. No statistically significant difference was revealed for adalimumab therapy. Significant risk factors for therapy ineffectiveness were the following: high body mass index (BMI) at the time of GEBT onset, aggravated family history, and prior use of one or several subsequent GEBT lines. Conclusion. The therapy survivability is inevitably declining over time. The best results were noted in bio-naive patients treated with ustekinumab that allows us to recommend it as the first-line drug in children with severe and moderate forms of psoriasis.

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“…49 There are now enough data from registers, cohorts and clinical trials to assess the real-world benefits and tolerance of adult treatments in adolescents. [50][51][52][53][54][55] In France, treatments can be prescribed for "off-label" use under the following circumstances: 1) there is no alternative licensed drug; 2) the treatment is recognized as effective and safe by the scientific community and literature; 3) the indication is "essential" with regard to the patient's condition, is necessary for the patient, and is consistent with current scientific knowledge; 4) the prescriber has informed the patient of the absence of official authorization for the prescription, the absence of therapeutic alternatives, the expected benefits, and the risks or constraints of the drug, as well as the conditions of health insurance coverage; and 5) justification for the prescription is recorded in the patient's medical file. 48 Recent national guidelines have been published for the management of psoriasis in children and adolescents in Germany, Italy and the United States.…”

Section: General Managementmentioning

confidence: 99%

“…Real-life data evaluating other factors, such as comparative drug survival, are now becoming available and will be of use during discussions concerning treatment choices. 50,53…”

Section: Conventional Systemic and Biologic Treatmentsmentioning

confidence: 99%

<p>Optimal Management of Plaque Psoriasis in Adolescents: Current Perspectives</p>

Mahé

2020

PTT

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The skin is at the interface between the body and its environment and is therefore at the center of adolescent concerns during this period of identity formation and increased awareness of body image issues, and stigmatization. Managing an adolescent with psoriasis involves managing the illness and the individual during their transition from being an older child to a young adult. In addition to ensuring that the patient adheres to treatments and is engaged with the therapeutic strategy, dermatologists may also need to manage issues linked to unspoken suffering or conflicts between the adolescent and their parents, who are often present during consultations. The impact of psoriasis on the social interactions, school life and sexuality of the patients, together with the influence of the internet and social networks, also have to be taken into account. In this review, we summarize the epidemiologic, clinical, and therapeutic data available on psoriasis in adolescents, and propose specific management strategies, adapted to the 21st century, for patients in this age group.

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Biological treatments for paediatric psoriasis : a retrospective observational study on biological drug survival in daily practice in childhood psoriasis

Cited by 29 publications

References 23 publications

Adalimumab in severe plaque psoriasis of childhood: A multi‐center, retrospective real‐life study up to 52 weeks observation

Adalimumab in severe plaque psoriasis of childhood: A multi‐center, retrospective real‐life study up to 52 weeks observation

Biological Therapy Survivability in Children with Psoriasis: Cohort Study

<p>Optimal Management of Plaque Psoriasis in Adolescents: Current Perspectives</p>

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