2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T43a,A total of 506 patients received 683 treatments: acitretin (n = 316), methotrexate (n = 245) and cyclosporine (n = 122). Median drug survival at 2 years was similar for acitretin (10.8 months) and methotrexate (10.9 months), but lower for cyclosporine (3.9 months; p < 0.0001). The most common reasons for discontinuation were inefficacy for cyclosporine (43.0%), and loss of effectiveness for acitretin (27.2%) and methotrexate (31.8%). No demographic, clinical or therapeutic characteristics were associated with higher rates of treatment maintenance at 6 months. Drug survival was higher for acitretin when used as a first-line therapy (median drug survival: 11.3 months for first-line vs. 5.5 months for second- or subsequent-line therapy; p < 0.001), but there were no differences for methotrexate and cyclosporine. Adverse events (AEs) were the reason for stopping treatment in 13.8% of patients on acitretin, 23.1% on methotrexate and 14.0% on cyclosporine (p = 0.02). Only one serious AE was reported: hepatitis in the methotrexate group.31:Tdc4,Three conventional systemic treatments, acitretin, methotrexate and cyclosporine, are used for severe childhood psoriasis. In many countries, they are the only treatments available. There are limited data and no comparative evaluations of these treatments. The international, multicentre, retrospective, real-world ACMe cohort was developed to assess the comparative 2-year drug survival of acitretin, methotrexate and cyclosporine in paediatric psoriasis. Thirty dermatology centres in France, Italy, Portugal, Canada and the United Kingdom participated in the study. Demographic and clinical data were collected using a standardized form for patients receiving treatment from 2014 to 2024. A total of 506 patients received 683 treatments: acitretin (n = 316), methotrexate (n = 245) and cyclosporine (n = 122). Median drug survival at 2 years was similar for acitretin (10.8 months) and methotrexate (10.9 months), but lower for cyclosporine (3.9 months; p < 0.0001). The most common reasons for discontinuation were inefficacy for cyclosporine (43.0%), and loss of effectiveness for acitretin (27.2%) and methotrexate (31.8%). No demographic, clinical or therapeutic characteristics were associated with higher rates of treatment maintenance at 6 months. Drug survival was higher for acitretin when used as a first-line therapy (median drug survival: 11.3 months for first-line vs. 5.5 months for second- or subsequent-line therapy; p < 0.001), but there were no differences for methotrexate and cyclosporine. Adverse events (AEs) were the reason for stopping treatment in 13.8% of patients on acitretin, 23.1% on methotrexate and 14.0% on cyclosporine (p = 0.02). Only one serious AE was reported: hepatitis in the methotrexate group. This cohort study showed that acitretin and methotrexate had comparable 2-year drug survival rates, which were superior to cyclosporine. We did not find any predictive factors for increased treatment maintenance except for first-line use of acitretin. AEs were a frequent reason for discontinuing treatments. These results may help develop treatment algorithms for systemic therapy in paediatric psoriasis. Severe forms of psoriasis may require the use of general treatments. Three usual treatments (acitretin, methotrexate and cyclosporine) are used for severe childhood psoriasis. In many countries, they are the only treatments available. In this international, multicentre, retrospective study, we compared the 2‐year drug survival (duration before stopping treatment) of these treatments in paediatric psoriasis. Thirty dermatology centres from five countries included 506 patients who received 683 treatments: acitretin (n = 316), methotrexate (n = 245) and cyclosporine (n = 122). Median drug survival at 2 years was similar for acitretin and methotrexate, but lower for cyclosporine. The most common reasons for discontinuation were inefficacy for cyclosporine and loss of effectiveness for acitretin and methotrexate. We did not identify demographic, clinical or therapeutic characteristics associated with higher rates of treatment maintenance at 6 months. Adverse events were the reason for stopping treatment in 13.8% of patients on acitretin, 23.1% on methotrexate and 14.0% on cyclosporine. This study showed that acitretin and methotrexate had comparable 2‐year drug survival rates, which were superior to cyclosporine. These results may help develop treatment algorithms for systemic therapy in pediatric psoriasis.32:Tb7c,AbstractBackgroundThree conventional systemic treatments, acitretin, methotrexate and cyclosporine, are used for severe childhood psoriasis. In many countries, they are the only treatments available. There are limited data and no comparative evaluations of these treatments.ObjectivesThe international, multicentre, retrospective, real‐world ACMe cohort was developed to assess the comparative 2‐year drug survival of acitretin, methotrexate and cyclosporine in paediatric psoriasis.MethodsThirty dermatology centres in France, Italy, Portugal, Canada and the United Kingdom participated in the study. Demographic and clinical data were collected using a standardized form for patients receiving treatment from 2014 to 2024.ResultsA total of 506 patients received 683 treatments: acitretin (n = 316), methotrexate (n = 245) and cyclosporine (n = 122). Median drug survival at 2 years was similar for acitretin (10.8 months) and methotrexate (10.9 months), but lower for cyclosporine (3.9 months; p < 0.0001). The most common reasons for discontinuation were inefficacy for cyclosporine (43.0%), and loss of effectiveness for acitretin (27.2%) and methotrexate (31.8%). No demographic, clinical or therapeutic characteristics were associated with higher rates of treatment maintenance at 6 months. Drug survival was higher for acitretin when used as a first‐line therapy (median drug survival: 11.3 months for first‐line vs. 5.5 months for second‐ or subsequent‐line therapy; p < 0.001), but there were no differences for methotrexate and cyclosporine. Adverse events (AEs) were the reason for stopping treatment in 13.8% of patients on acitretin, 23.1% on methotrexate and 14.0% on cyclosporine (p = 0.02). Only one serious AE was reported: hepatitis in the methotrexate group.ConclusionsThis cohort study showed that acitretin and methotrexate had comparable 2‐year drug survival rates, which were superior to cyclosporine. We did not find any predictive factors for increased treatment maintenance except for first‐line use of acitretin. AEs were a frequent reason for discontinuing treatments. These results may help develop treatment algorithms for systemic therapy in paediatric psoriasis.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Systemic Retinoid: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Systemic Retinoid (modality). Clinician-written summaries and actionable practice insights. 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Both AIH and macular erythema can persist months to years and may impair quality of life more than active acne itself. Treatment options include topical agents (azelaic acid, retinoids, hydroquinone, antioxidants), systemic therapies (isotretinoin, oral antibiotics, oral tranexamic acid), chemical peels, lasers, and microneedling.","limitations":"No validated patient-reported outcome measures specific to AIH or acne-induced macular erythema currently exist; the article is a narrative review without a systematic literature search or meta-analysis, limiting the strength of evidence-based recommendations.","practice_takeaway":"For patients with skin of color presenting with post-acne hyperpigmentation, prioritize strict photoprotection alongside targeted depigmenting agents (e.g., azelaic acid, retinoids, hydroquinone) and treat active acne aggressively to reduce new lesions. Oral tranexamic acid and energy-based devices are additional options, but skin phototype must guide procedural choices to minimize risk of further pigmentary change."}},{"doi":"10.1111/jdv.70108","pmid":"41104794","title":"Drug survival of systemic treatments for severe paediatric psoriasis: An international retrospective study","journal_title":"Journal of the European Academy of Dermatology and Venereology","journal_issn":"0926-9959","published_at":"2025-10-17T00:00:00.000Z","url":"https://doi.org/10.1111/jdv.70108","source_score":15,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-10-22","doi":"10.1111/jdv.70108","days":"14","issn":"0926-9959","rank":"9","field":"Clinical Medicine","score":"15","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1111/jdv.70108","title":"Drug survival of systemic treatments for severe paediatric psoriasis: An international retrospective study.","journal":"Journal of 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France"}]},{"given":"Alain","family":"Beauchet","sequence":"additional","affiliation":[{"name":"Department of Public Health Centre Hospitalier Universitaire Raymond Poincaré, Assistance Publique‐Hôpitaux de Paris Garches France"}]},{"given":"Maryam","family":"Piram","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Pediatrics, CHU Sainte‐Justine Research Center Université de Montréal Montréal Quebec Canada"}]},{"given":"Tess","family":"McPherson","sequence":"additional","affiliation":[{"name":"Department of Dermatology Oxford University Hospitals NHS Trust Oxford UK"}]},{"given":"Tiago","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centro Académico Clínico, ICBAS/Santo António University of Porto Porto Portugal"}]},{"given":"Yasmine","family":"Yesli","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Pediatrics, CHU Sainte‐Justine Research Center Université de Montréal Montréal Quebec Canada"}]},{"given":"Hélène","family":"Aubert","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hôtel‐Dieu Centre Hospitalier Universitaire de Nantes Nantes France"}]},{"given":"Christine","family":"Bodemer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dermatology, Centre Hospitalier Universitaire Necker‐Enfants Malades Assistance Publique‐Hôpitaux de Paris Paris France"}]},{"given":"Cristina","family":"Bertoli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Arcispedale Santa Maria Nuova Azienda USL‐IRCCS di Reggio Emilia Reggio Emilia Italy"}]},{"given":"Mathilde","family":"Tardieu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dermatology Centre Hospitalier Universitaire Grenoble Alpes Grenoble France"}]},{"given":"Thomas","family":"Hubiche","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hôpital Archet 2 Nice 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Acitretin had longer survival when used first line (11.3 vs 5.5 months; p<0.001).","limitations":"Retrospective, non-randomized design. The abstract does not detail how multiple treatment courses per patient (683 courses in 506 patients) were handled analytically.","practice_takeaway":"Expect shorter persistence with cyclosporine than with acitretin or methotrexate over 2 years; only acitretin showed better persistence when started first line. Adverse events prompted discontinuation in 13.8% (acitretin), 23.1% (methotrexate), and 14.0% (cyclosporine), with one serious event (hepatitis) on methotrexate."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Systemic Retinoid"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Systemic Retinoid"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Systemic Retinoid"}}}]]

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