Adult Drug Effective in Treating Psoriasis in Children

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To assess whether or not the drug was as safe and effective in children under 17 as it is in adults, Paller and her colleagues recruited 211 children and adolescents with moderate to severe psoriasis to participate in the trial.

Paller said the researchers chose etanercept, because it's already being used to treat children with juvenile rheumatoid arthritis and appears to be safe in that population.

The study volunteers, all between the ages of 4 and 17, were randomly assigned to receive 12 weeks of once-weekly injections of 0.8 milligrams (mg) of etanercept or a placebo. After the initial 12-week phase of the study, everyone was put on once-weekly etanercept for 24 weeks. Finally, at 36 weeks, 138 study volunteers were randomly chosen again to receive either etanercept or a placebo.

After 12 weeks, 57 percent of those on etanercept showed a 75 percent or greater improvement in their symptoms, compared with 11 percent on a placebo. During the 24 weeks when everyone received etanercept, 68 percent of those who had initially been on etanercept and 65 percent of those who started on a placebo showed a 75 percent or greater response.

During the second "randomized" portion of the trial, 42 percent of those placed on a placebo began having symptoms again.

Several children experienced infections while on etanercept, but all recovered without complications, according to the study.

"This is an incredible result," Paller said. "What's really exciting is we were worried because we were using a pretty low amount of etanercept. In adults who achieved the same blood levels of etanercept, there was a 30 to 34 percent response [of 75 percent or more]. Kids clearly are showing a better response than adults," she added.

The study was funded by Immunex, the manufacturer of Enbrel.

"This study was not a surprise. Etanercept has been approved for several years for psoriasis. It's very effective in adults and has a reasonably good safety record," said Dr. Mark Lebwohl, chairman of the medical advisory board of the National Psoriasis Foundation, and chairman of the department of dermatology at Mt. Sinai School of Medicine in New York City.

"Children with psoriasis grow up with a stigma; they get made fun of. Psoriasis has a profound psychological impact as well as a physical impact. Effective treatment really changes the lives of these kids in a very beneficial way," Lebwohl said.

More information

To learn more about psoriasis, visit the U.S. National Library of Medicine.