Adalimumab combined with acitretin in the treatment of five children with generalized pustular psoriasis: a retrospective clinical observation
10.35541/cjd.20210458
- VernacularTitle:阿达木单抗联合阿维A治疗5例儿童泛发性脓疱型银屑病回顾性分析
- Author:
Jia LIAN
1
;
Lixin CHEN
;
Ying WANG
;
Tiantian BI
;
Yuantao SONG
;
Qinfeng LI
Author Information
1. 天津市儿童医院皮肤科，天津 300074
- Keywords:
Psoriasis;
Child;
Therapy;
Acitretin;
Tumor necrosis factor-alpha;
Generalized pustular psoriasis;
Adalimumab
- From:
Chinese Journal of Dermatology
2022;55(10):916-918
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy and safety of adalimumab combined with acitretin in the treatment of childhood generalized pustular psoriasis.Methods:Five children with generalized pustular psoriasis were collected from Department of Dermatology, Tianjin Children′s Hospital from October 2019 to August 2020. After admission, the patients received oral acitretin at a dose of 0.5 mg·kg -1·d -1. After relevant laboratory examinations, these patients additionally received subcutaneous injections of 20- or 40-mg adalimumab at weeks 0 (the initial dose) , 1, and every 2 weeks thereafter; when patients obtained a 50% improvement in the Japanese Dermatology Association (JDA) severity index score, the dose of acitretin would be reduced to 0.3 mg·kg -1·d -1, and acitretin would be discontinued after a 75% improvement. The disease condition was evaluated at weeks 0, 1, 2, 4, 8, 12 and 24 after the start of adalimumab treatment, and adverse reactions were monitored during treatment. Results:All the 5 patients received drug treatment for at least 40 weeks. After 2-week treatment, 3 patients achieved a 50% reduction in JDA severity index score (JDA50) ; after 4-week treatment, 4 achieved JDA75, and 1 achieved JDA100; after 8-week treatment, all the 5 patients achieved JDA100. By June 2021, all the 5 children received follow-up for at least 40 weeks, no recurrence was observed during the treatment period, and no infections, malignant tumors or other serious adverse reactions occurred.Conclusion:Adalimumab combined with acitretin shows rapid onset of action and high safety in the treatment of childhood generalized pustular psoriasis.
