Dr Amy Paller: Safety Is of Paramount Importance When Choosing Systemic Therapies for Children With AD

Amy S. Paller, MD, chair of the department of dermatology at Northwestern University's Feinberg School of Medicine, noted that safety is of paramount importance when choosing which systemic therapy to use to treat children with atopic dermatitis (AD).

Specifically, Paller claimed that biologics are currently the safest to use in children, but she explained that, as more is learned about them, Janus kinase (JAK) inhibitors may take over that title in the years to come.

Conversely, Paller noted that the long-term side effects of systemic therapies are not yet known, which, she emphasized, providers must be aware of when using them to treat children with AD.

Transcript

What are the long-term risks of systemic therapy use in children with AD?

One of the factors that we need to be concerned about with systemic medications in children is that we're talking about longer term than what we may be talking about [for] an adult who's taking a medication. If we start at 2 or 3 years of age, 6 years of age, 10 years of age, we've got a few decades more, potentially, than what we might be doing in treating an adult.

So, we do pay attention to safety; that's of paramount importance in any systemic therapy we choose for children. Right now, we think that the biologics are safest, but we also may, in a few years, as we learn more about the JAK inhibitors, feel very comfortable with their use, including in children who have atopic dermatitis for years on end.

However, of course, it may take a long period of time before we know about the long-term side effects, even of the biologics, and we have to be aware of that in using them for our patients who are very young with atopic dermatitis.