Even though etanercept has been used off-label for years; the management of moderate to severe plaque psoriasis in children will be dramatically transformed due to its recent approval by the US Food and Drug Administration. This approval by the FDA will allow the TN-alpha inhibitor to become an integral part of the standard of care for children with resistant psoriasis.
The two biggest issues have always been safety and effectiveness. Studies conducted during the last ten years utilizing etanercept to treat pediatric arthritis as well as pediatric psoriasis confirms success of this biologic agents safety and effectiveness. Hopefully this will lead to more research in order to expand the amount of equipment, methods and techniques available for the management of this debilitating disease that has multiple comorbidities such as metabolic syndrome and cardiovascular disease.
Helping kids cope with skin diseases
Current treatments for adolescents with moderate to severe plaque psoriasis should continue to include topical agents and phototherapy. Systemic agents; however, should still be considered for use when topical therapy and phototherapy fail to achieve the intended results. An FDA Advisory Board Meeting that took place in the spring of 2015, came to the same conclusion. They also stated that new agents which are currently being studied in adults, (including methotrexate, phosphodiesterase inhibitors, cyclosporine, mycophenolate and newer biologic agents) should be studied in children, as soon as results report success in safety and effectiveness.
At the end of the day, it is our mission to introduce pediatric practitioners to the new data on etanercept (Paller AS, et al. Long-term safety and efficacy of etanercept in children and adolescents with plaque psoriasis. J Am Acad Dermatol. 2016;74:280-287.e3) for kids with resistant psoriasis and make sure they are ready for other therapeutic options down the road.