Abstract
Background and Objectives: Severe, recalcitrant cases of pediatric psoriasis or atopic dermatitis may necessitate treatment with biological agents; however, this may be difficult due to lack of treatment options and standardized treatment guidelines. This review evaluates the biological treatment options available, including off-label uses, and provides a basic therapeutic guideline for pediatric psoriasis and atopic dermatitis. Materials and Methods: A PubMed review of biological treatments for pediatric psoriasis and atopic dermatitis with information regarding age, efficacy, dosing, contra-indications, adverse events, and off-label treatments. Results: Currently there are three European Medicines Agency (EMA)-approved biological treatment options for pediatric psoriasis: etanercept, ustekinumab, and adalimumab. While dupilumab was recently Food and Drug Administration (FDA)- and EMA-approved for adult atopic dermatitis, it is still not yet approved for pediatric atopic dermatitis. Conclusions: Given the high morbidity associated with pediatric atopic dermatitis and psoriasis, there is a need for more treatment options. Further research and post-marketing registries are needed to extend the use of biologics into pediatric patients.
Highlights
Dermatologic conditions in pediatric populations, such as atopic dermatitis (AD) and psoriasis (Ps), put children at an increased risk for low self-esteem, depression, anxiety, social isolation, and suicidal ideation [1,2,3]
Given the high morbidity associated with pediatric atopic dermatitis and psoriasis, there is a need for more treatment options
While the number of biologic agents to treat dermatologic conditions in adult patients has expanded in the past decade, biologic options available for pediatric AD and Ps remain limited
Summary
Dermatologic conditions in pediatric populations, such as atopic dermatitis (AD) and psoriasis (Ps), put children at an increased risk for low self-esteem, depression, anxiety, social isolation, and suicidal ideation [1,2,3]. These diseases impact a patient’s quality of life, and warrant early recognition and treatment to decrease their risk of physical and psychologic morbidity. While the number of biologic agents to treat dermatologic conditions in adult patients has expanded in the past decade, biologic options available for pediatric AD and Ps remain limited. We hope this review will inform providers on the indications, safety, and treatment efficacy of biologic therapies in pediatric and adolescent patients with AD or Ps
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