Luu M, Cordoro K M
Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
Skin Therapy Lett. 2013 Feb;18(2):1-4.
The exact role of biologics in the treatment of pediatric psoriasis remains undefined but is evolving. Biologics are an attractive option for use in children in part because they offer more convenient dosing regimens and less frequent laboratory monitoring than traditional systemic agents. Further, because their action is targeted, they theoretically lack many of the potential end-organ toxicities of traditional agents. However, compared to adult psoriasis populations, there is a relative lack of long-term safety data specific to the pediatric psoriasis population. Thus, the clear advantages of using biologic agents must be balanced with a measure of caution. This article will provide a summary of the cumulative pediatric safety and efficacy data for the anti-tumor necrosis factor-alpha (TNF-α) agents and interleukin (IL)-12 and IL-23 (IL12/23) pathway inhibitor and suggestions for a rational clinical approach to their use in children with psoriasis.
生物制剂在儿童银屑病治疗中的确切作用尚未明确，但仍在不断发展。生物制剂是儿童治疗的一个有吸引力的选择，部分原因是与传统全身用药相比，它们提供了更方便的给药方案且实验室监测频率更低。此外，由于其作用具有靶向性，理论上它们缺乏传统药物许多潜在的终末器官毒性。然而，与成人银屑病患者群体相比，针对儿童银屑病患者群体的长期安全性数据相对较少。因此，使用生物制剂的明显优势必须与一定程度的谨慎相权衡。本文将总结抗肿瘤坏死因子-α（TNF-α）制剂、白细胞介素（IL）-12和IL-23（IL12/23）通路抑制剂在儿童中的累积安全性和疗效数据，并就其在儿童银屑病患者中的合理临床应用方法提出建议。
