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. 2025 Apr;37(2):114-121.
doi: 10.5021/ad.24.057.

The Efficacy, Safety and Longevity of Biologic Treatments in Pediatric and Adult Psoriasis Patients: A Comparative Multi-Center, Real-Life Study

Özlem Akın Çakıcı  1 , Zeynep Topkarcı  2 , Begüm Yurtsever Güneş  3 , Nahide Onsun  3 , Dilek Seçkin  4 , Tülin Ergun  4
Affiliations

The Efficacy, Safety and Longevity of Biologic Treatments in Pediatric and Adult Psoriasis Patients: A Comparative Multi-Center, Real-Life Study

Özlem Akın Çakıcı et al. Ann Dermatol. 2025 Apr.

Abstract

Background: Evidence on the effectiveness, long-term safety and longevity of biologic therapies in pediatric psoriasis patients is sparse.

Objective: 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.

Methods: 293 biologic treatment cycles of 198 patients (62 pediatric and 136 adult) from three academic psoriasis referral centres were analysed.

Results: 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 (p>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; p=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.

Conclusion: 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.

Keywords: Biologics; Psoriasis; Skin diseases; Treatment efficacy.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Kaplan-Meier survival curves for drug survival of etanercept, adalimumab and ustekinumab in pediatric patients.
Fig. 2
Fig. 2. Kaplan-Meier survival curves for drug survival of infliximab, etanercept, ustekinumab, adalimumab in adult patients.
See this image and copyright information in PMC

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