There are few FDA-approved psoriasis treatments for children. “So, access to treatment is often a challenge. And treatment with topical corticosteroid monotherapy is just sub-optimal,” she says.
Insurance carriers can deny coverage for expensive psoriasis medications that don’t have pediatric labeling. Even when the drugs are covered, out-of-pocket expenses can be too much for families.
There is a lack of long-term safety data that follow children with psoriasis on systemic medications. And, there is only one published head-to-head efficacy study. This small 16-week trial, conducted in Canada and Europe, found a only a small trend in greater efficacy of the higher parenteral dose (0.8 mg/kg every other week) of adalimumab compared to a relatively low oral dose of methotrexate (0·1-0·4 mg/kg per week) in children over age 4, Dr. Siegfried said.
“In moving forward, it would really be wonderful to have more robust clinical trials with active comparator rather than placebo controls, but this is only feasible when both drugs are FDA-approved,” she said.
Dr. Siegfried is a principal investigator for Allergan, Amgen, Eli Lilly and Company, Mayne Pharma Group, Pierre Fabre Dermo-Cosmetique US and Regeneron. She is on the advisory board of Pfizer and Verrica Pharmaceuticals, is a consultant to Valeant Pharmaceuticals North America, and is on the Data Safety Monitoring Board of GlaxoSmithKline.