TY - JOUR
T1 - Biologics for pediatric psoriasis
T2 - A systematic review and meta-analysis
AU - Sun, Helen Y.
AU - Phan, Kevin
AU - Paller, Amy S.
AU - Sebaratnam, Deshan F.
N1 - Funding Information:
We are grateful to the University of New South Wales BSc(Med)Hons Program for their support of Miss Helen Sun.
Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - 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.
AB - 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.
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U2 - 10.1111/pde.14870
DO - 10.1111/pde.14870
M3 - Article
C2 - 34888919
AN - SCOPUS:85120919503
VL - 39
SP - 42
EP - 48
JO - Pediatric Dermatology
JF - Pediatric Dermatology
SN - 0736-8046
IS - 1
ER -