Treatment of severe psoriasis in children: Recommendations of an Italian expert group

Ketty Peris, Gaia Moretta, Anna Belloni Fortina, Federico Bardazzi, Samantha Berti, Claudia Carnevale, Vito Di Lernia, Maya El Hachem, Iria Neri, Carlo Mario Gelmetti, Viviana Lora, Carlo Mazzatenta, Mirella Milioto, Annalisa Patrizi, Alberto Villani

Risultato della ricerca: Contributo in rivistaArticolo in rivista

28 Citazioni (Scopus)

Abstract

This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment’s approval by the European Medicines Agency for childhood psoriasis and the experts’ opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥6 and ≥ 12 years, respectively. Conclusion: A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies.
Lingua originaleEnglish
pagine (da-a)1339-1354
Numero di pagine16
RivistaEuropean Journal of Pediatrics
Volume176
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Biologics
  • Consensus
  • Pediatric
  • Pediatrics, Perinatology and Child Health
  • Psoriasis
  • Systemic therapy

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