Efficacy and safety of biologics and small molecules for psoriasis in pediatric and geriatric populations. Part I: focus on pediatric patients

ABSTRACT

Introduction

Psoriasis management is challenging, especially in pediatric age for different factors. The introduction of biologic drugs and oral small molecules (OSM) revolutionized the armamentarium of available weapons in psoriasis treatment. Despite the use of these drugs in adult patients has been widely investigated, pediatric patients have often been unconsidered in clinical trials and real-life studies. However, the high efficacy and speed of action, the safety profile and the ease-to-use administration make these innovative drugs an invaluable therapeutic opportunity.

Areas covered

The aim of this manuscript is to perform a review of the current literature examining data on the effectiveness and safety of biologic drugs and OSM for the management of psoriasis in pediatric patients in order to put the basis for universally shared treatment algorithm following available evidence. PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines were used for the literature research.

Expert Opinion/Commentary

Our review based on currently available evidence suggests biologics and OSM as an ideal treatment option for pediatric patients, with an excellent profile in terms of efficacy and safety as compared to traditional systemic drugs.

KEYWORDS:

• Psoriasis
• pediatric
• childhood
• treatment
• biologics
• small molecules

Article highlights

• Psoriasis management in pediatric age may be challenging for different factors.

• Even if biologics and small molecules revolutionized psoriasis management, there are few data on the use of these drugs in pediatric patients as they have often been unconsidered in clinical trials and real-life studies.

• Our review examining all existing trials and real-life data suggests biologics and small molecules as appropriate treatment option for pediatric patients.

• An excellent profile in terms of efficacy and safety as compared to traditional systemic drugs has been found for biologics and small molecules in pediatric patients.

This box summarizes key points contained in the article.

Declaration of interests

M Megna acted as a speaker or consultant for Abbvie, Novartis, Eli Lilly, Janssen, UCB, Amgen, Leo Pharma. G Fabbrocini acted as a speaker or consultant for Abbvie, Novartis, Eli Lilly, Janssen, UCB, Amgen, Leo Pharma, Almirall, Sanofi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One reviewer has received research, speaking and/or consulting support from Eli Lilly and Company, GlaxoSmithKline/Stiefel, AbbVie, Janssen, Alovtech, vTv Therapeutics, Bristol-Myers Squibb, Samsung, Pfizer, Boehringer Ingelheim, Amgen, Dermavant, Arcutis, Novartis, Novan, UCB, Helsinn, Sun Pharma, Almirall, Galderma, Leo Pharma, Mylan, Celgene, Ortho Dermatology, Menlo, Merck & Co, Qurient, Forte, Arena, Biocon, Accordant, Argenx, Sanofi, Regeneron, the National Biological Corporation, Caremark, Teladoc, Eurofins, Informa, UpToDate and the National Psoriasis Foundation. They are the founder and part owner of Causa Research and hold stock in Sensal Health. The remaining reviewers have no other relevant financial relationships or otherwise to disclose.

Author contribution statement

M Megna: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. E Camela: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. T Battista: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. L Genco: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. F Martora: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. M Noto: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. V Picone: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. A Ruggiero: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. G Monfrecola: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. G Fabbrocini: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. L Potestio: data curation, formal analysis, investigation, visualization, writing-original draft preparation, writing - review & editing. All authors read and approved the final version of the manuscript.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Additional information

Funding

This paper was not funded.