Biologics for pediatric psoriasis: A systematic review and meta-analysis

Helen Y. Sun, Kevin Phan, Amy S. Paller, Deshan F. Sebaratnam*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Biologics represent a promising treatment for children with moderate-to-severe psoriasis. Randomized control trials (RCTs) have been published evaluating different biologics in children with psoriasis, but no summative review exists. Objective: To summarize data from existing RCTs to assess the efficacy and safety of biologics in the management of pediatric psoriasis. Methods: A systematic review and meta-analysis of RCTs was performed from Medline, Embase, PubMed, the Cochrane Central Register of Controlled Trials, and the American College of Physicians Journal Club from inception to November 2020. Random-effects models were used to estimate the pooled effect size. Results: Five RCTs assessing adalimumab, etanercept, ixekizumab, secukinumab, and ustekinumab were included (768 patients). The odds ratio of achieving a 75% improvement in Psoriasis Area and Severity index score was 12.37 (95% CI: 6.23-24.55) at initial follow-up, defined as 12-16 weeks of treatment. The odds ratio of any adverse event was 0.95 (95% CI: 0.51-1.80) at initial follow-up, in patients treated with biologics when compared to placebo or a non-biologic agent. Limitations of this study include heterogeneity in both the study design and the biologics investigated between the RCTs included in the meta-analysis. Conclusion: Biologic therapy for pediatric patients with moderate-to-severe psoriasis has high efficacy and a favorable side effect profile.

Original languageEnglish (US)
JournalPediatric dermatology
DOIs
StateAccepted/In press - 2021

Keywords

  • adolescent
  • biological therapy
  • child
  • psoriasis
  • quality of life

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dermatology

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