Treating paediatric psoriasis

1. Technology appraisal guidance [TA455] www.nice.org.uk/guidance/ta455

2. Am J Clin Dermatol (2017) doi: 10.1007/s40257-017-0294-9.

NICE recently issued guidance on treatments for paediatric plaque psoriasis¹. One third of cases of psoriasis emerge during childhood².

NICE recommends adalimumab for plaque psoriasis in children and young people aged 4 years or older, etanercept for patients aged 6 years or older and ustekinumab for those aged 12 years or older. Children should have severe psoriasis (total Psoriasis Area and Severity Index [PASI] ≥10) that has not responded to standard systemic therapy (such as ciclosporin, methotrexate or phototherapy) or these options are contraindicated or not tolerated.

NICE suggests stopping etanercept after 12 weeks, and adalimumab and ustekinumab after 16 weeks, if the psoriasis has not responded adequately (≥75% reduction in the PASI). Healthcare professionals should, NICE remarks, consider how skin colour might affect the PASI score.