What’s new and old in treatments for pediatric dermatology
Abstract
Several biologics for the treatment of psoriasis in children have received expanded indications from Health Canada in the past year. Ustekinumab, an IL12/23 inhibitor, was approved in June 2020 for the treatment of chronic, moderate-to-severe plaque psoriasis in patients 6 to 17 years of age who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapy.
The approved dosing is weight- based with injections at 0, 4 and then every 12 weeks thereafter. The expanded indication is based on CADMUS Junior, a phase III open-label single arm study of 44 children aged 6 to <12 years with moderate-to-severe psoriasis for at least 6 months and a PASI score of ≥12. At week 12, 77% of patients achieved PGA 0/1, 84% achieved PASI75 and 64% achieved PASI90 response. Ustekinumab’s onset of action resulted in approximately 25% of patients achieving PASI75 by week 4, and almost 60% of patients by week 8. The most common adverse effects reported were nasopharyngitis (25%) and infections requiring treatment (27%). Overall, 34 patients (77%) had at least one adverse event.
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