Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials
BackgroundBiological agents have been used with extreme caution in children because of their possible adverse effects.ObjectivesThis study used high-quality randomized controlled trials (RCTs) to provide high-level evidence to assess the effectiveness and safety of biological agents for treating chi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.896550/full |
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| author | Xiao-ce Cai Xiao-ce Cai Yi Ru Yi Ru Liu Liu Liu Liu Xiao-ying Sun Xiao-ying Sun Ya-qiong Zhou Ya-qiong Zhou Ying Luo Ying Luo Jia-le Chen Jia-le Chen Miao Zhang Miao Zhang Chun-xiao Wang Chun-xiao Wang Bin Li Bin Li Bin Li Xin Li Xin Li |
| author_facet | Xiao-ce Cai Xiao-ce Cai Yi Ru Yi Ru Liu Liu Liu Liu Xiao-ying Sun Xiao-ying Sun Ya-qiong Zhou Ya-qiong Zhou Ying Luo Ying Luo Jia-le Chen Jia-le Chen Miao Zhang Miao Zhang Chun-xiao Wang Chun-xiao Wang Bin Li Bin Li Bin Li Xin Li Xin Li |
| author_sort | Xiao-ce Cai |
| collection | DOAJ |
| description | BackgroundBiological agents have been used with extreme caution in children because of their possible adverse effects.ObjectivesThis 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.MethodsWe 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.ResultsSix 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 < 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.LimitationsInclusion of few relevant, high-quality RCTs.ConclusionThe 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. |
| first_indexed | 2024-12-10T18:36:23Z |
| format | Article |
| id | doaj.art-61b9a1b82c2542058cb9f6bba22f0ad6 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-10T18:36:23Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-61b9a1b82c2542058cb9f6bba22f0ad62022-12-22T01:37:47ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-08-011310.3389/fimmu.2022.896550896550Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trialsXiao-ce Cai0Xiao-ce Cai1Yi Ru2Yi Ru3Liu Liu4Liu Liu5Xiao-ying Sun6Xiao-ying Sun7Ya-qiong Zhou8Ya-qiong Zhou9Ying Luo10Ying Luo11Jia-le Chen12Jia-le Chen13Miao Zhang14Miao Zhang15Chun-xiao Wang16Chun-xiao Wang17Bin Li18Bin Li19Bin Li20Xin Li21Xin Li22Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaShanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaInstitute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, ChinaBackgroundBiological agents have been used with extreme caution in children because of their possible adverse effects.ObjectivesThis 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.MethodsWe 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.ResultsSix 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 < 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.LimitationsInclusion of few relevant, high-quality RCTs.ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fimmu.2022.896550/fullbiological agentspediatricpsoriasisadverse eventsBayesian analysissystematic review |
| spellingShingle | Xiao-ce Cai Xiao-ce Cai Yi Ru Yi Ru Liu Liu Liu Liu Xiao-ying Sun Xiao-ying Sun Ya-qiong Zhou Ya-qiong Zhou Ying Luo Ying Luo Jia-le Chen Jia-le Chen Miao Zhang Miao Zhang Chun-xiao Wang Chun-xiao Wang Bin Li Bin Li Bin Li Xin Li Xin Li Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials Frontiers in Immunology biological agents pediatric psoriasis adverse events Bayesian analysis systematic review |
| title | Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials |
| title_full | Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials |
| title_fullStr | Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials |
| title_full_unstemmed | Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials |
| title_short | Efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis: A bayesian analysis of six high-quality randomized controlled trials |
| title_sort | efficacy and safety of biological agents for the treatment of pediatric patients with psoriasis a bayesian analysis of six high quality randomized controlled trials |
| topic | biological agents pediatric psoriasis adverse events Bayesian analysis systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.896550/full |
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