Rate of Skin Clearance Linked to Quality of Life in Children With Psoriasis

Children with psoriasis with higher rates of skin clearance experience an enhanced quality of life compared with children with lower rates of skin clearance, according to an analysis of results from the IXORA-PEDS trial published in Pediatric Dermatology.

Investigators used data from the IXORA-PEDS trial, a 108-week, multicenter, double-blind, randomized, placebo-controlled phase III study, which found ixekizumab (IXE) superior to placebo for skin clearance and improved quality of life in pediatric patients. The patients were aged 6 to 18 years with moderate to severe plaque psoriasis who were also candidates for phototherapy or systemic therapy or whose psoriasis was not adequately controlled with topical therapies. Investigators randomly assigned patients 2:1 to receive either subcutaneous ixekizumab (IXE) every 4 weeks or placebo. After week 12, all patients received IXE in an open-label period for 48 weeks.

The primary outcome of this study was the association between Children’s Dermatology Life Quality Index (CDLQI) or DLQI (for patients aged >16 years) scores and skin clearance and efficacy in challenging body areas, evaluated at weeks 12 and 48.

There were 171 patients included in the study, with 166 entering the maintenance period and 152 completing week 48. The mean age was 13.5 (SD, 3) and 57.9% were female.

There were significantly higher DLQI and CDLQI scores in patients with greater levels of skin clearance at weeks 12 and 48 as measured by Psoriasis Area Severity Index (PASI) (P <.0001), static Physician’s Global Assessment (sPGA), and Psoriasis Scalp Severity Index (PSSI) (P <.0001). Patients with greater levels of palmoplantar clearance had higher DLQI and CDLQI scores at week 12 (P =.0139) but not at week 48. There was no significant association between CDLQI and DLQI and Nail Psoriasis Severity Index (NAPSI) at either week 12 or week 48.

The study was limited by the small population size.

Investigators noted that their findings demonstrate that “pediatric patients with psoriasis may derive greater benefit from achieving more complete levels of overall skin and scalp clearance,” they wrote.

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Hebert AA, Bobonich MA, Rodriguez Capriles C, et al. Higher rates of skin clearance and efficacy in challenging body areas are associated with better health-related quality of life following ixekizumab maintenance treatment in pediatric patients with plaque psoriasis. Pediatr Dermatol. Published online December 20, 2021. doi:10.1111/pde.14892