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Examining the safety of pediatric psoriasis treatment

A new investigation looks at the safety of psoriasis treatment in pediatric cases.

Psoriasis has many treatment options, and an increasing number of cases are being treated with systemic medication. The safety of such medications is not well known, but a new investigation in the Journal of the American Academy of Dermatology provides some new safety data.1

The researchers used insurance claims data to identify children aged younger than 18 years who had psoriasis. They compared the frequency of serious infections among patients who initiated biologics, systemic nonbiologics, and phototherapy.

The claims data included 57,323 children with psoriasis. Among these children, the 6-month risk of infection was 1.1 per 1000 patient-years in 2657 phototherapy initiators, 5.1 per 1000 patient-years in 988 systemic nonbiologic initiators, and 4.2 per 1000 patient-years in 722 biologic initiators. Relative risk of infection in nonbiologics versus phototherapy was 5.00; in biologics versus phototherapy, it was 1.50; and in biologics versus nonbiologics, it was 0.67. Overall, the background risk of infection was 1 per 1000 in children who had psoriasis, which was roughly double the risk in children who didn’t have psoriasis.

Investigators concluded that there was very little difference in the risk of infection for biologics versus nonbiologics or systemic medication users versus phototherapy. 


1.    neeweiss MC, Huang JT, Wyss R, Schneeweiss S, Merola JF. Serious infection risk in children with psoriasis on systemic treatment: a propensity score-matched population-based study. J Am Acad Dermatol. 2020;82(6):1337-1345.