Secukinumab for the Treatment of Psoriasis in Pediatrics: Patient Selection and Acceptability

Abstract

Psoriasis (PsO) is a chronic, systemic, immune-mediated inflammatory skin disease affecting 1% to 5% population worldwide. In one-third of patients, the first symptoms of PsO manifest in childhood, with a mean age of nine years. Psoriasis in children under 16 years of age constitutes 4% of dermatological problems in this age group. Chronic inflammation of the skin observed in PsO is associated with a development of potentially serious comorbidities, including psoriatic arthritis, hypertension, metabolic syndrome, cardiovascular diseases, inflammatory bowel disease, depression and anxiety. It is reported that among children with psoriasis between 5 and 16 years of age health-related quality of life is reduced by 30.5%. Early diagnosis and effective treatment are crucial in pediatric psoriatic patients to avoid future complications and stigmatization. Treatment for psoriasis consists of a range of topical medications, phototherapy and non-biologic and biologic systemic therapies. Approved biologics for PsO in pediatric patients include etanercept, adalimumab, ustekinumab, ixekizumab and secukinumab. Secukinumab, a recombinant, fully human monoclonal antibody targeting IL-17A, was approved by the EMA (2020) and FDA (2021) in pediatric patients above 6 years of age for the treatment of moderate to severe plaque psoriasis who are candidates for systemic therapy. This review discusses the selection and acceptability of secukinumab in children with psoriasis.

Mediating the Role of Perceived Social Support Between Frailty and Self-Perceived Burden in Elderly Patients with Diabetes

“…It could allow them to better handle depression, anxiety and other emotions caused by physical, psychological and social frailty. 4 If an elderly patient who suffers from high physical frailty due to diabetes remains in a state of stress and seldom receives social support from family, friends and society, they will be unwilling to communicate with others, raising their SPB level. Hence, it is imperative not only to secure the material foundation but also to empower individuals to exercise subjective initiative in alleviating (SPB).…”

“…2 Self-perceived burden (SPB) refers to negative emotions such as anxiety, depression and loneliness, which are caused by physical worries about the illness and psychological stress that encompasses feelings of guilt, dependence and fear of imposing a burden on others during the care-receiving process. 3 Recent studies 4 have shown that the frailty arising from chronic diseases among elderly patients is in close connection with SPB. Frailty is a senile syndrome mainly characterised by decreased physiological reserve function, multiple organ dysfunction, increased organismal vulnerability and declining anti-stress ability.…”

Advancements in Ichthyosis Treatment in Pediatric Patients: Evaluating the Impact of Immune System Inhibitors Targeting TNF-alpha, IL-17A, IL-4, and IL-12

“…In particular, secukinumab resulted in a 48% decrease in the Ichthyosis-Area-Severity-Index score following a 6-month therapy term in a young patient with severe erythrodermic Ichthyosis associated with ABCA12 deficiency in a therapeutic trial. Treatment was well tolerated, and the patient's blood cytokine profile consistently changed, showing a decrease in proinflammatory cytokines and a Th17-skewing (Albela et al, 2024;Narbutt et al, 2023;Yogarajah et al, 2021).…”

Il‐17 inhibitor in patient with juvenile psoriasis and primary immunodeficiency

“…Recently, secukinumab was approved for the treatment of moderate to severe plaque psoriasis in pediatric patients above 6 years of age. 8 Nevertheless, there was a dilemma concerning the initiation of biological therapy as it may lead to heightened vulnerability to infections or exacerbate autoimmune processes, potentially resulting in paradoxical inflammation or even triggering autoimmune disease. 9 We have previously encountered a situation where we administered adalimumab to patient with immunodeficiency as a part of DiGeorge syndrome and uncontrolled juvenile idiopathic arthritis.…”