Is the future clear?
How can we treat Mia next?
Despite a slight improvement, currently approved biologics in Europe failed to achieve the desired result of significantly alleviating Mia’s symptoms. With the condition having such a large impact on Mia and her parents, her physician decided to discuss the option of IL-17 inhibitors and other treatments that are currently in trials.
The future is looking hopeful for Mia, IL-17 inhibitors may be an option for her. Ixekizumab has been recently approved for use in children with moderate-to-severe psoriasis by the FDA1 and the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has adopted a positive opinion for secukinumab for children from six years with moderate-to-severe psoriasis2. This suggests that IL-17 inhibitors will join the list of available options for treating paediatric patients with psoriasis in Europe. Continue on to view the data.
Is the future clear for Mia and her skin?
Clinical trials are ongoing for more targeted biologic therapies
The IL-17A inhibitor secukinumab (NCT036686131, NCT024711442) and the IL-17R inhibitor brodalumab (NCT032408093) are in paediatric clinical trials for psoriasis along with the IL-23 inhibitors guselkumab (NCT034518514) and tildrakizumab (NCT039977865), and certolizumab pegol (NCT041237956).
Preliminary data suggests adult treatments are also effective in children
While limited data from clinical trials has been reported, results appear to be consistent, if not better than, adult data.
Professor Paller gives us her summary of the efficacy and safety in children vs adult data.
Having well-controlled psoriasis in paediatric patients will reduce the impact of psoriasis in later life
There is concern that undertreating children may facilitate the ‘psoriatic march’ from severe untreated inflammation in childhood and its associations to cardiovascular morbidity and mortality in adults12.
Professor Vakirlis describes why early treatment is so important.
References
- Clinicaltrials.gov. Study to assess the long-term safety, tolerability, efficacy of secukinumab in pediatric patients of age 6 to <18 years, with moderate to severe plaque psoriasis. Available at: https://clinicaltrials.gov/ct2/show/NCT03668613. Accessed 14 May 2020.
- Clinicaltrials.gov. Pediatric study in children and adolescents with severe plaque psoriasis. Available at: https://clinicaltrials.gov/ct2/show/NCT02471144. Accessed 14 May 2020.
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