PDF Source for ‘Cyclosporine (CysA) is effective for psoriasis in adult patients but little data exist about its efficacy and safety in childhood and adolescence psoriasis. Effectiveness and safety of cyclosporine in pediatric plaque psoriasis: A multicentric retrospective analysis. Biologics Childhood Pediatric psoriasis Systemic treatments. Moreover, a recent Italian multicenter retrospective analysis of 38 psoriatic children showed CsA to be an effective and well-tolerated treatment. Effectiveness and safety of cyclosporine in pediatric plaque psoriasis: a multicentric retrospective analysis. Cyclosporine (CysA) is effective for psoriasis in adult patients but little data exist about its efficacy and safety in childhood and adolescence psoriasis. Effectiveness and safety of cyclosporine in pediatric plaque psoriasis: a multicentric retrospective analysis.
Gisondi P. Effectiveness and safety of cyclosporine in pediatric plaque psoriasis: A multicentric retrospective analysis. J Dermatolog Treat. 2015 Dec 10:1-4. Cyclosporine, effective and well-tolerated as paediatric plaque psoriasis treatment. A prospective, multicenter, international registry is needed to evaluate these treatments in a standardized manner and ultimately to develop international guidelines on pediatric psoriasis. In childhood, typical erythematous plaques with overlying white scale are often thinner and smaller and psoriasis lesions tend to develop more often on the face and flexural areas. It is an effective and safe treatment option for pediatric psoriasis 32, 36. Effectiveness and safety of fumaric acid esters in children with psoriasis: a retrospective analysis of 14 patients from The Netherlands.
Severe disease Severe psoriasis requires phototherapy or systemic therapies such as retinoids, methotrexate, cyclosporine, apremilast, or biologic immune modifying agents. However, high quality studies on the efficacy and safety of therapies for psoriasis in children are limited. Although topical vitamin D analogs are effective as monotherapy for some patients, a systematic review found that combination therapy with a topical corticosteroid is more effective than either treatment alone 24. National Psoriasis Foundation guide to phototherapy. 33Spuls, P.I., Hadi, S., Rivera, L. et al, Retrospective analysis of the treatment of psoriasis of the palms and soles. Cyclosporin is safe and effective in severe atopic dermatitis of childhood. L.F. et al, Long-term etanercept in pediatric patients with plaque psoriasis. The long-term safety profile of continuous FAE treatment is favorable without an increased risk for infections, malignancies, or other serious adverse events. The 2009 European evidence-based S3-guidelines on psoriasis treatment recommend FAE and suggest it as a first-line systemic treatment for moderate-to-severe plaque psoriasis. In addition, FAE have been proven to be effective in multiple sclerosis,29,30 and FAE became approved as treatment for multiple sclerosis by the FDA and the European Medicines Agency in 2013. Effectiveness and safety of fumaric acid esters in children with psoriasis: a retrospective analysis of 14 patients from The Netherlands.
Psoriasis is a complex, chronic, multifactorial, inflammatory disease that involves hyperproliferation of the keratinocytes in the epidermis, with an increase in the epidermal cell turnover rate (see the image below). Plaque psoriasis: Most commonly affects the extensor surfaces of the knees, elbows, scalp, and trunk. Cyclosporine, generally used intermittently for inducing a clinical response with one or several courses over a 3 to 6 months. Transition from conventional systemic therapy to a biologic agent, either directly or with an overlap if transitioning is needed due to lack of efficacy, or with a treatment-free interval if transitioning is needed for safety reasons. Although the efficacy of methotrexate and cyclosporine on plaque type psoriasis has been reported previously, the literature consists of few publications regarding the efficacy of the two treatment agents in the nail involvement. A retrospective analysis of 48 patients with nail involvement confirmed the efficacy of infliximab therapy in nail psoriasis, with rapid and persistent improvements. Thirteen children with nail psoriasis were treated with potent topical steroid ointments for onycholysis and nail bed hyperkeratosis; however, the results were unsatisfactory 82. Methotrexate, cyclosporine and retinoids are the most commonly used conventional systemic drugs. The drug has also been reported to be safe and effective in childhood psoriasis. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. D. Cyclosporine in psoriasis: a multicenter dose-finding study in severe plaque psoriaisis. Et al, Cyclosporine in severe psoriasis: results of a meta-analysis in 579 patients. Freeman, K. et al, Long-term efficacy and safety of cyclosporine in severe, adult atopic dermatitis. An analysis was conducted of randomized clinical trials evaluating biologic and oral systemic medications and phototherapy for patients with moderate to severe psoriasis. 7 FDA-approved treatments for moderate to severe psoriasis, which affects approximately 33 of psoriasis patients,2 have burgeoned since 2003, when only acitretin, cyclosporine, methotrexate, and phototherapy were available. 14 English-language studies that enrolled adults 18 years or older who had a diagnosis of predominantly plaque-type moderate to severe psoriasis were included.