Volume 62, Issue 6 , Pages 1013-1030, June 2010
Efficacy and safety of treatments for childhood psoriasis: A systematic literature review
Background
Evidence-based recommendations for therapeutic decision making in childhood psoriasis are lacking.
Objectives
We sought to systematically review all available literature concerning treatment efficacy and safety in childhood psoriasis and to propose a recommendation for topical and systemic treatment of childhood psoriasis.
Methods
Databases searched were PubMed, EMBASE, and the Cochrane Controlled Clinical Trial Register. All studies reporting on efficacy and safety of all treatment options in childhood psoriasis were obtained and a level of evidence was determined.
Results
Literature search revealed 2649 studies, of which 64 studies met the inclusion criteria. The majority of topical and systemic therapies given in childhood psoriasis are efficacious. Short-term side effects were usually mild; long-term side effects were not described.
Limitations
Most conclusions formulated are not based on randomized controlled trials.
Conclusions
A rough summary of the proposed algorithm is as follows: first, calcipotriene with/without topical corticosteroids, followed by dithranol. Methotrexate is considered to be the systemic treatment of choice.
Key words: childhood psoriasis, efficacy, safety, treatment
Abbreviations used: LOE, level of evidence, MTX, methotrexate, NB, narrowband, PASI, Psoriasis Area and Severity Index, PUVA, psoralen plus ultraviolet A, RCT, randomized controlled trial, UV, ultraviolet
Supported by University Medical Center St Radboud Foundation, which received funding from Wyeth Pharmaceuticals for the project. Wyeth Pharmaceuticals played no role in the design and execution of the study or in data collection, data management, data analysis, interpretation of the data, manuscript preparation, manuscript review, or manuscript approval.
Conflicts of interest: None declared.
Disclosure: Dr de Jager participated in trials funded by Schering Plough and Abbott. Dr de Jong served as consultant for Biogen, Serono, Wyeth, and Abbott. She also received research grants from Merck Serono and Wyeth. Dr van de Kerkhof served as consultant for Schering Plough, Cellgene, Centocor, Allmirall, UCB, Wyeth, Pfizer, Soffinova, Abbott, Actelion, Galderma, Novartis, Janssen Cilag, and Leo Pharma. He also received research grants from Centocor, Wyeth, Schering Plough, Merck Serono, Abbott, and Philips Lighting. Dr Seyger has served as a consultant for Wyeth and participated in trials funded by Schering Plough and Wyeth.
PII: S0190-9622(09)00780-4
doi:10.1016/j.jaad.2009.06.048
© 2009 American Academy of Dermatology, Inc. Published by Elsevier Inc All rights reserved.
Volume 62, Issue 6 , Pages 1013-1030, June 2010
