In:
Frontiers in Immunology, Frontiers Media SA, Vol. 13 ( 2022-8-19)
Abstract:
Biological agents have been used with extreme caution in children because of their possible adverse effects. Objectives This study used high-quality randomized controlled trials (RCTs) to provide high-level evidence to assess the effectiveness and safety of biological agents for treating children with psoriasis. Methods We searched PubMed, Embase, Cochrane, and Web of Science databases through October 31, 2021. We included trials reporting at least one adverse event after treatment with biological agents of patients less than 18-year-old diagnosed with psoriasis. RevMan 5.3 and Stata 15.0 software were used for meta and Bayesian analyses. Results Six trials with 864 participants were included in the analysis. The results showed a 2.37-fold higher response rate in all biologics groups than in the control group for psoriasis area and severity index 75 (PASI75) (RR= 2.37, P- value & lt; 0.01, 95% confidence interval [CI] [1.22, 4.62] ). Compared with placebo, the PASI75 response rates of etanercept (RR= 2.82, 95% [CI] [1.10, 7.21] ), ustekinumab low dose (RR= 7.45, 95%[CI] [1.25, 44.58] ), and ustekinumab high dose (RR= 7.25, 95%[CI] [1.21, 43.41] ) were superior. Additionally, the incidence of total adverse reactions was 1.05 times higher for biologics than for controls, indicating a good safety profile (RR= 1.05, P- value = 0.53, 95%[CI] [0.92, 1.19] ). Overall, these six high-quality randomized controlled trials suggest that biologics are effective and safe for pediatric patients with psoriasis. Limitations Inclusion of few relevant, high-quality RCTs. Conclusion The results of this study indicate that biologics can be used to treat children with moderate-to-severe psoriasis without the risk of adverse effects. Ustekinumab showed the best efficacy and the fewest adverse effects.
Type of Medium:
Online Resource
ISSN:
1664-3224
DOI:
10.3389/fimmu.2022.896550
DOI:
10.3389/fimmu.2022.896550.s001
DOI:
10.3389/fimmu.2022.896550.s002
DOI:
10.3389/fimmu.2022.896550.s003
DOI:
10.3389/fimmu.2022.896550.s004
DOI:
10.3389/fimmu.2022.896550.s005
DOI:
10.3389/fimmu.2022.896550.s006
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2022
detail.hit.zdb_id:
2606827-8
Bookmarklink