Acitretin efficacy and safety in childhood and adolescent psoriasis

[Fred]

This is a small study looking at the efficacy and safety of Acitretin in childhood and adolescent psoriasis patients.

Quote:

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Background:
Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis.

Methods:
Retrospective analysis of a group of children and adolescents (<17 years of age) with moderate to severe plaque psoriasis treated with acitretin between 2010 and 2014 at Italian dermatology clinics. Patients were identified through databases or registries.

Results:
The study population consisted of 18 patients with a median age of 9.5 years at the start of therapy. The median maintenance dosage per day was 0.41 mg/kg. Eight patients (44.4%) achieved complete clearance or good improvement of their psoriasis, defined as improvement from baseline of 75% or more on the Psoriasis Area and Severity Index at week 16. Three had three or more courses of treatment with short disease-free intervals. In three patients, acitretin treatment was ongoing at the time of data collection. The mean total duration of treatment in responders was 22.7 months. One patient discontinued treatment because of arthralgia. The remaining nine patients (50%) discontinued treatment because it was ineffective. Mucocutaneous adverse effects occurred in all patients, but did not affect therapy maintenance.

Conclusions:
In this retrospective case series, acitretin was a moderately effective, well-tolerated treatment in children with moderate to severe plaque psoriasis. Given the small number of patients, statements about long-term safety are not possible.

Source: onlinelibrary.wiley.com

*Early view funding unknown.

Acitretin

[jiml]

That's interesting and may be a comfort to some parents of young sufferers, who are struggling with the disease during a child's formative years . Although I would have to look at other alternatives first. This may go some way to lift a child's self esteem and help them fit in

[Fred]

That's interesting and may be a comfort to some parents of young sufferers, who are struggling with the disease during a child's formative years . Although I would have to look at other alternatives first. This may go some way to lift a child's self esteem and help them fit in

I don't have children but it's not something I would want my child on. I would rather go down other routes first and try to encourage them to live with it like we had to in the old days with creams, they have the rest of their lives to put up with it so save the stronger stuff till last I say. (Exception being psoriatic arthritis in the young, it's bad enough as an adult and a Kid needs to enjoy life as much as possible)

[mataribot]

It's a guy only treatment at that age. That drug takes three years off someone who wants a kid. You cannot have a kid make that type of decision - it's cruel.

[Kit]

It's a guy only treatment at that age.  That drug takes three years off someone who wants a kid. You cannot have a kid make that type of decision - it's cruel.

From what I've learned about this drug - and I'm using it myself at this time - I feel that it should not even be an option for females unless it is known that they are physically unable to have kids - ever. 

Even a mature adult female should never feel obliged to make that decision. The risk of bearing a damaged or deformed child is extremely high, almost a certainty.  Confusingly the time required for Acitretin to leave the system is 3 years in the US and just 2 years in some other countries. It would also be a lot more reassuring if there was an international consensus on the potency of the drug too.  
So it's not only cruel to have a parent make that decision on behalf of their female child, I feel it's a cruel option for any female who may at any time in the future be capable of having kids.