Monoclonal Antibody Effective in Pediatric Patients With Psoriasis

The biologic secukinumab is safe and effective for pediatric patients with psoriasis, explained authors in a recent review article published in Patient Preference and Adherence. 

“Secukinumab, a recombinant, fully human monoclonal antibody targeting IL-17A, was approved by the European Medicines Agency (2020) and the US Food and Drug Administration (2021) in pediatric patients above 6 years of age for the treatment of moderate to severe plaque psoriasis who are candidates for systemic therapy,” reported clinicians from the Medical University of Lodz Department of Dermatology in Poland in the piece.

In addition to high effectiveness, secukinumab has demonstrated rapid and sustained clinical response in clinical trials and case studies. One of the main disadvantages of the treatment in children, however, is its route of administration.

“Subcutaneous injections can be not well tolerated due to needle phobia, which is common in pediatric population,” the review explained. “However, it is possible to use various techniques that reduce discomfort and anxiety during the injection, such as diverting the child’s attention or application of cold compresses.”

Additionally, relatively infrequent administration may help its acceptability in younger patients, the authors advised. 

Although rare, serious adverse events have occurred in pediatric clinical trials of secukinumab. Case reports have also described severe infections associated with the biologic, including staphylococcal toxic shock syndrome in a 6-year-old girl with psoriasis and necrotizing fasciitis in a patient with severe combined immunodeficiency, according to the review. Since anti-IL17 medications may worsen inflammatory bowel disease (IBD), secukinumab is not recommended for patients with IBD.

“Individualized and holistic medical care ongoing with close monitoring, as well as good contact between doctors and parents or legal guardians of patients, can help in safe treatment with secukinumab,” the authors advised.

Reference:
Narbutt J, Niedźwiedź M, Lesiak A, Ceryn J, Skibińska M. Secukinumab for the treatment of psoriasis in pediatrics: patient selection and acceptability. Patient Prefer Adherence. 2023;17:421-431. doi:10.2147/PPA.S350753