Secukinumab, a fully human monoclonal antibody that targets IL-17A, is a promising treatment option in pediatric patients aged 6 years and above with moderate to severe plaque psoriasis.
Psoriasis is a chronic and inflammatory skin disease that affects 1% to 5% of the global population. It is caused by T-cell activity and genetic and epigenetic factors, and can manifest in childhood. Chronic inflammation associated with psoriasis can lead to serious comorbidities, such as obesity, type 2 diabetes, and depression. Children with psoriasis often face social stigma due to their skin lesions, which can lead to social isolation and difficulties in learning. Early diagnosis and effective treatment are crucial for pediatric psoriasis patients to avoid future complications and stigmatization.
This review, published in the journal Patient Preference and Adherence, discusses secukinumab for the treatment of pediatric psoriasis.
The Use of Biologics for Treating Moderate-to-Severe Psoriasis
Biologics such as etanercept, adalimumab, ustekinumab, ixekizumab, and secukinumab are commonly used to treat moderate-to-severe psoriasis in pediatric patients. About 25% of pediatric patients with psoriasis receive biologic treatment at some point, but their accessibility may be limited in some countries. Treatment choice should consider specific circumstances, such as comorbidities, pregnancy, and chronic infections. Although biologics are effective, it is still unclear which biologic treatment is best for pediatric patients due to a lack of long-term data. Healthcare professionals should evaluate each patient’s individual circumstances when determining the appropriate treatment plan.
Targeting IL-17 With Secukinumab for the Treatment of Psoriasis
IL-17 plays a significant role in psoriasis development by stimulating the production of inflammatory substances. Effective treatment strategies that target IL-17 and other cytokines involved in psoriasis pathogenesis are crucial for managing this chronic condition. One way to do this is by blocking the IL-17 pathway, which can be accomplished by either blocking the receptors or directly blocking the molecule. One such treatment is secukinumab, a fully human monoclonal antibody that targets IL-17A.
Approval of Secukinumab for Pediatric Psoriasis Treatment by EMA and FDA
The European Medicine Agency (EMA) and the Food and Drug Administration (FDA) have approved this treatment’s use in pediatric patients who are 6 years or older, have moderate-to- severe plaque psoriasis, and qualify for systemic therapy or phototherapy. By targeting IL-17A, secukinumab can effectively manage psoriasis and improve the quality of life for patients.
Secukinumab: A Promising Treatment for Pediatric Psoriasis
Secukinumab has been demonstrated to be effective and safe in clinical trials. A trial with 162 children and adolescents showed that both low and high doses of secukinumab resulted in greater clinical improvement compared to etanercept, with higher efficacy seen in the high-dose group. Quality of life also improved in both groups, and secukinumab was well-tolerated, with mild adverse effects reported. Another trial, for patients aged 6 to 18 years with moderate-to- severe chronic plaque psoriasis, showed that both low and high doses of secukinumab resulted in improvements in Psoriasis Area and Severity Index score and Investigator’s Global Assessment score over 52 weeks of treatment. If a low dose of secukinumab is ineffective, patients weighing 50 kg or more should be considered for a higher dose.
In conclusion, secukinumab is a promising treatment option for pediatric patients with psoriasis, providing a safe and effective way to manage this chronic condition. Close monitoring and individualized care are essential to ensuring the best possible outcomes for patients undergoing this treatment. More studies are needed to fully understand its long-term effects.
Source:
Narbutt, J., Niedźwiedź, M., Lesiak, A., Ceryn, J., & Skibińska, M. (2023). Secukinumab for the Treatment of Psoriasis in Pediatrics: Patient Selection and Acceptability. Patient Prefer Adherence, 17, 421-431. https://doi.org/10.2147/ppa.S350753
