Topical Management of Pediatric Psoriasis: A Review of New Developments and Existing Therapies

by Selleckchem | Dec 09 2023

Psoriasis is a chronic immune-mediated disorder that commonly affects adults and children. In recent years, pediatric psoriasis has increased in prevalence and the disease is often associated with various comorbidities and psychological distress. The conventional topical treatments for psoriasis, such as corticosteroids, calcineurin inhibitors, vitamin D analogs, anthralin, and coal tar, are often limited by their side effects, tolerability, and/or efficacy, particularly for use in children and on sensitive and intertriginous areas. Recently, the US Food and Drug Administration approved two new topical non-steroidal agents for treating psoriasis that target different pathogenic pathways than the conventional treatments. Roflumilast is a phosphodiesterase type 4 inhibitor approved for the treatment of plaque psoriasis in patients aged 12 years and older. Tapinarof is a novel aryl hydrocarbon receptor modulator approved for adult psoriasis and currently undergoing studies for pediatric psoriasis. Ongoing efforts are also being made to optimize conventional treatments, for instance, a new foam formulation of halobetasol propionate was recently approved for pediatric psoriasis. Clinical trials of various new drugs targeting one or multiple pathogenic pathways of psoriasis, such as Janus kinase inhibitors, different formulations of phosphodiesterase type 4 inhibitors, and aryl hydrocarbon receptor modulators have also been explored. The recent emergence of novel topical agents provides promising new options for managing pediatric psoriasis with the potential to improve clinical outcomes and quality of life. In this article, we review the mechanism of action, efficacy, and safety profile of novel topical agents and discuss their potential roles in the management of pediatric psoriasis.

Comments:

It's great to see that advancements are being made in the treatment of pediatric psoriasis. The approval of new topical agents and the ongoing research into various drugs targeting different pathways offer hope for improved outcomes and quality of life for patients. Let's delve into the mechanisms of action, efficacy, and safety profiles of the mentioned novel topical agents, Roflumilast and Tapinarof, as well as touch upon the potential roles they play in managing pediatric psoriasis.

### Roflumilast:

**Mechanism of Action:** Roflumilast is a phosphodiesterase type 4 inhibitor. It works by reducing inflammation. Phosphodiesterase type 4 is an enzyme that plays a role in the inflammatory process. By inhibiting this enzyme, Roflumilast helps decrease inflammation in the skin.

**Efficacy and Safety:** Clinical trials have demonstrated the efficacy of Roflumilast in treating plaque psoriasis in patients aged 12 years and older. Its safety profile is a crucial aspect, especially in pediatric patients. The approval by the FDA suggests that the benefits of this medication outweigh its potential risks for individuals within this age group.

**Potential Role in Pediatric Psoriasis:** Roflumilast provides an alternative treatment option for pediatric patients who may not respond well to conventional therapies or experience adverse effects from them. Its targeted mechanism of action can be particularly beneficial in managing inflammation associated with psoriasis.

### Tapinarof:

**Mechanism of Action:** Tapinarof is a novel aryl hydrocarbon receptor modulator. It works by modulating the activity of certain receptors in the skin cells. By doing so, it helps regulate the immune response and reduce inflammation.

**Efficacy and Safety:** Tapinarof has shown promise in adult psoriasis and is currently undergoing studies for pediatric psoriasis. Its specific mechanism of action, targeting aryl hydrocarbon receptors, offers a unique approach to managing psoriasis-related inflammation. Safety data from ongoing studies will be essential in determining its overall risk-benefit profile in pediatric patients.

**Potential Role in Pediatric Psoriasis:** Tapinarof, being a novel agent, holds potential for pediatric psoriasis management, especially if it proves to be effective and safe in this population. Its unique mechanism of action differentiates it from conventional treatments, providing an additional option for patients.

### Ongoing Research and Optimized Conventional Treatments:

Apart from these novel agents, ongoing research into Janus kinase inhibitors, different formulations of phosphodiesterase type 4 inhibitors, and other pathways targeting drugs highlights the commitment to finding diverse and effective treatments for pediatric psoriasis.

Additionally, the development of new formulations, such as the foam formulation of halobetasol propionate, demonstrates efforts to optimize existing treatments. These formulations aim to enhance the delivery of medications, making them more effective and potentially reducing side effects, especially in sensitive and intertriginous areas in pediatric patients.

In conclusion, the emergence of these novel topical agents, along with ongoing research and optimized conventional treatments, is promising for the management of pediatric psoriasis. However, the safety and efficacy of these treatments in the pediatric population need to be continually studied and monitored to ensure the best possible outcomes for young patients. As research progresses, these advancements offer hope for improved quality of life for individuals living with pediatric psoriasis.