Amgen's apremilast (Otezla) has recently become available in the US for pediatric patients aged 6 years and older with moderate to severe plaque psoriasis, marking a significant advancement in treatment options. This development coincides with increased attention to disparities in psoriasis care, particularly for patients with skin of color, highlighting the need for tailored approaches and inclusive research.
Apremilast for Pediatric Psoriasis
Apremilast received FDA approval in April 2024 for pediatric use and is the first and only oral medication approved in the US for young patients with moderate to severe plaque psoriasis. To be eligible for this treatment, pediatric patients must weigh at least 20 kg (44 lb) and be considered candidates for phototherapy or systemic therapy.
Leah Howard, JD, president and CEO of the National Psoriasis Foundation (NPF), emphasized the importance of pediatric-specific research, noting that treatments approved for adults must be thoroughly tested for safety and efficacy in younger populations due to physiological differences.
Impact on Patients and Families
The availability of oral medications like apremilast offers practical benefits for families. Trisha, the mother of a 10-year-old girl with plaque psoriasis, shared that oral medications are significantly easier to administer compared to weekly or monthly injections, reducing the day-to-day stress associated with managing the condition.
Addressing Disparities in Psoriasis Care
The fourth annual Science of Skin event underscored the importance of addressing disparities in psoriasis care, particularly for patients with skin of color. Chesahna Kindred, MD, MBA, FAAD, highlighted that psoriasis often presents differently in these patients, leading to misdiagnosis and a greater impact on quality of life.
"Another layer of the impact is just a misdiagnosis, and we know in dermatology that different diseases can look alike...Add the extra layer that if it’s a patient with melanin-rich skin, it also can look different," Kindred explained.
She stressed the necessity of including diverse populations in clinical trials to ensure the effectiveness of new treatments across all skin types.
Advocacy and Policy
Patient advocacy organizations like the NPF play a vital role in bridging the gap between research advancements and patient care. Howard emphasized the importance of advocacy in promoting research and ensuring that new treatments are accessible and effective for all patients, including underserved populations like children.
Recommendations for Clinicians
Howard and Kindred offered advice for clinicians to stay engaged with patient advocacy organizations and approach the diagnosis and treatment of patients with skin of color with cultural competence and humility.
