Effectiveness and Safety of Acitretin in Children with Plaque Psoriasis: A Multicenter Retrospective Analysis

• DOI: 10.1111/pde.12940
• Publication Date: 2016-07-22T09:12:49Z
• Authors: Vito Di Lernia; Domenico Bonamonte; Claudia Lasagni; Anna Belloni Fortina; Stefano Cambiaghi; Monica Corazza; Sergio Di Nuzzo; Paolo Gisondi; Michele Panzone; Claudio Guarneri; Iria Neri
• Keywords: Male; Pediatrics, Perinatology and Child Health; Medicine (all); 2708; Adolescent; Databases, Factual; Keratolytic Agent; 610; Acitretin; Adolescent; Age Factors; Child; Child, Preschool; Cohort Studies; Databases, Factual; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Keratolytic Agents; Male; Patient Safety; Psoriasis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Treatment Outcome; Pediatrics; Risk Assessment; Severity of Illness Index; Drug Administration Schedule; Follow-Up Studie; Dose-Response Relationship; Cohort Studies; Databases; 03 medical and health sciences; Keratolytic Agents; 0302 clinical medicine; Retrospective Studie; 616; Humans; Psoriasis; Age Factor; Preschool; Child; Factual; Retrospective Studies; Psoriasi; Dose-Response Relationship, Drug; Age Factors; Perinatology and Child Health; Acitretin; 3. Good health; Treatment Outcome; Child, Preschool; Female; Patient Safety; Cohort Studie; Drug; Human; 2708; Follow-Up Studies

AbstractBackgroundAcitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis.MethodsRetrospective 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.ResultsThe 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.ConclusionsIn 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.