The study included 211 children and teens from 42 sites in the U.S. and Canada treated during the first 12 weeks with either once-weekly injections of placebo or up to 50 milligrams of Enbrel, depending on body weight.
After the initial 12 weeks of treatment, all the patients were treated with Enbrel for the following 24 weeks; then patients were again randomly assigned to treatment with either Enbrel or placebo for an additional 12 weeks to examine the effect of withdrawal.
The researchers reported that 68% of patients initially treated with Enbrel and 65% of those initially treated with placebo showed 75% improvement in lesions and other symptoms at week 36 of the trial.
Withdrawal from the drug was associated with a significant return of psoriasis lesions in 42% of patients.
"Our responses were as good as those seen in studies in adults with about half the dosage," Paller says. "We really don't know why that is."
Dermatologist and psoriasis expert Mark G. Lebwohl, MD, says he is not surprised by the findings.
"[Enbrel] has become the leading systemic treatment for adults with psoriasis in the U.S., so you would expect it to work just as well in children," he says.
He adds that the safety of the drug in children has been shown in juvenile rheumatoid arthritis studies.
The chairman of the dermatology department at New York City's Mount Sinai Medical Center, Lebwohl tells WebMD that while many patients show dramatic improvement while taking biologic drugs like Enbrel, Remicade, Humira, and Raptiva, a significant percentage does not.
He says more drugs are needed and cites certain investigational drugs as being particularly promising for the treatment of psoriasis.
"The effects [in clinical trials] have been quite dramatic, and they seem to work for almost everybody," he says.