By week 2 of secukinumab (Cosentyx) treatment, most pediatric patients with generalized pustular psoriasis (GPP) achieved complete symptom resolution, with improvements in disease severity and quality of life sustained through week 70. This underscores the long-term efficacy and safety of secukinumab in this patient population.
The retrospective study, published in the Journal of Dermatological Treatment, enrolled patients aged 0 to 12 years diagnosed with GPP based on the International Psoriasis Council criteria. Patients received secukinumab from July 2021 to July 2024, with dosing adjusted based on age: 75 mg for children aged 0 to 3 years and 150 mg for those aged 3 to 12 years. The treatment regimen included weekly subcutaneous doses for the first 4 weeks, followed by doses every 4 weeks for 6 months, transitioning to every 8 weeks for 6 months, and finally every 12 weeks.
All 10 patients in the study demonstrated a positive response to secukinumab, with significant improvements in GPPASI, JDA, and IDLQI/CDLQI scores. By week 12, all patients achieved a JDA score of 0 and GPPASI-100, with sustained efficacy observed through the long-term treatment period. Despite some flare-ups during follow-up, these were promptly managed with resumed secukinumab treatment, leading to rapid symptom resolution.
Quality of life showed significant improvements from baseline, with sustained benefits despite temporary increases following recurrences. Adverse events were mild, primarily involving upper respiratory symptoms, conjunctivitis, or local injection site reactions, and did not necessitate treatment discontinuation. Overall, secukinumab was well-tolerated, demonstrating consistent efficacy and safety in managing pediatric GPP over the long-term.
The researchers acknowledged limitations, including a small sample size and the study being conducted exclusively at Kunming Children’s Hospital, which may introduce center-specific biases and reduce the diversity of the patient population. However, they believe the study demonstrates that secukinumab is an effective and safe long-term treatment for pediatric GPP.
