Çakıcı Özlem Akın, Topkarcı Zeynep, Güneş Begüm Yurtsever, Onsun Nahide, Seçkin Dilek, Ergun Tülin
Department of Dermatology, Marmara University School of Medicine, Istanbul, Republic of Türkiye.
Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Republic of Türkiye.
Ann Dermatol. 2025 Apr;37(2):114-121. doi: 10.5021/ad.24.057.
Evidence on the effectiveness, long-term safety and longevity of biologic therapies in pediatric psoriasis patients is sparse.
This study aims to compares the efficacy, safety and drug survival (DS) rates of etanercept (ETA), adalimumab (ADA), infliximab (INF), ustekinumab (UST), secukinumab (SEC) and ixekizumab (IXE) in pediatric and adult psoriasis patients.
293 biologic treatment cycles of 198 patients (62 pediatric and 136 adult) from three academic psoriasis referral centres were analysed.
The following were the Psoriasis Area and Severity Index 90 response scores of pediatric and adult psoriasis patients, respectively: ETA, 42.3% vs. 34.6%; ADA, 53.8% vs. 59.8%; INF, 33.3% vs. 33.3%; UST, 76.5% vs. 56.8%; SEC, 60% vs. 60%; and IXE, 50% vs. 87.5%. The differences of responses between the two groups were statistically insignificant (>0.05). ETA had the longest mean DS time in the pediatric group but it was related to a significantly shorter DS in pediatric patients than in adults (pediatrics: 30.58 [18.64-42.52] months vs. adults: 72.34 [54.70-89.99] months; =0.025). ADA had the longest mean DS time in the adult group with 101.28 [84.88-117.68] months. All treatments had favorable safety profiles. No specific severe adverse effects necessitating treatment discontinuation were observed in pediatric patients.
Although responses to ETA and UST were numerically better among children, the difference was insignificant. The DS rates in each group were comparable, and no specific safety signals, limiting the long-term use of these agents, were detected in the pediatric group.
关于生物疗法在儿童银屑病患者中的有效性、长期安全性和持久性的证据很少。
本研究旨在比较依那西普（ETA）、阿达木单抗（ADA）、英夫利昔单抗（INF）、乌司奴单抗（UST）、司库奇尤单抗（SEC）和依奇珠单抗（IXE）在儿童和成人银屑病患者中的疗效、安全性和药物生存期（DS）率。
分析了来自三个学术性银屑病转诊中心的198例患者（62例儿童和136例成人）的293个生物治疗周期。
儿童和成人银屑病患者的银屑病面积和严重程度指数90反应评分分别如下：ETA，42.3%对34.6%；ADA，53.8%对59.8%；INF，33.3%对33.3%；UST，76.5%对56.8%；SEC，60%对60%；IXE，50%对87.5%。两组之间的反应差异无统计学意义（>0.05）。ETA在儿童组中的平均DS时间最长，但与儿童患者相比，其DS明显短于成人（儿童：30.58[18.64 - 42.52]个月对成人：72.34[54.70 - 89.99]个月；P = 0.025）。ADA在成人组中的平均DS时间最长，为101.28[84.88 - 117.68]个月。所有治疗的安全性概况良好。在儿童患者中未观察到需要停药的特定严重不良反应。
尽管儿童对ETA和UST的反应在数值上更好，但差异不显著。每组的DS率相当，且在儿童组中未检测到限制这些药物长期使用的特定安全信号。
