In Pediatric Patients, Long-Term Adalimumab Treatment Effective for Reducing Psoriasis Severity

A young child scratching her irritated skin.
A young child scratching her irritated skin.
Adalimumab 0.8 mg/kg every other week was effective in a population of children and adolescents affected by moderate to severe plaque psoriasis, results of a real-life clinical experience show.

In children with severe plaque psoriasis, treatment with adalimumab was effective for reducing disease severity during a 52-week period. This is according to study data published in Dermatologic Therapy.

The study was a retrospective analysis of patients aged <17 years who began treatment with adalimumab for severe chronic plaque psoriasis with or without psoriatic arthritis from June 2016 and December 2017 (n=54). Severe psoriasis was defined as a psoriasis severity area index (PASI) ≥10 or psoriasis present in face, hands, or foot, with inadequate response to topical therapy.

Efficacy of therapy was defined as achievement of a PASI 75 and PASI 90 at weeks 16, 24, and 52. Response to therapy was compared in patients who had never received biologic therapy and those who had. The researchers also assessed safety by examining the number of patients who experienced ≥1 adverse event. The median PASI score at baseline was 14.7 ± 7.0.

The percentage of patients who achieved a 90% PASI score reduction and a 75% PASI score reduction at week 16 were 29.6% and 55.5%, respectively. By week 24, PASI 90 response increased to 55.5% and PASI 75 response increased to 74.0%. The absolute PASI values at week 16, week 24, and week 52 were 4.4 (interquartile range [IQR], 1.0-7.0), 2.5 (IQR, 0.0-3-0), and 4.6 (IQR, 0.0-4.0), respectively.

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No difference was observed in patients who had received biologic therapy vs those who had not with regard to the PASI response rates. Treatment discontinuation was reported in 11.3% (n=6) at week 16 because of lack of efficacy. No serious infections were observed during the 52-week treatment period.

Limitations of the study include its retrospective design, lack of randomization to active treatment and a control, and the small sample size.

The researchers added that these findings “may expand knowledge regarding the use of adalimumab as a long-term treatment option for pediatric patients with severe plaque psoriasis.”

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Di Lernia V, Bianchi L, Guerriero C, et al. Adalimumab in severe plaque psoriasis of childhood: a multi-center, retrospective real-life study up to 52 weeks observation [published online October 3, 2019]. Dermatol Ther. doi:10.1111/dth.13091