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Existing and Emerging Targeted Therapies in Juvenile Psoriatic Arthritis: Challenges and Unmet Needs

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Abstract

Juvenile psoriatic arthritis (JPsA) is a heterogeneous type of non-systemic chronic inflammatory arthritis affecting children and young people. This review focuses on highlighting challenges in harmonising recommendations for the use of available therapies in JPsA, according to its distinct clinical phenotypes, and explores the similarities and differences between the disease classification and management across age. We further explore the emerging therapeutic landscape, summarising the recently completed clinical trials in JPsA, and ongoing studies in both JPsA and adults with psoriatic arthritis, highlighting unmet needs and barriers for translational research in JPsA. The novel therapeutic agents in clinical development in JPsA range from monoclonal antibodies targeting interleukin (IL)-17, IL-12/23 and IL-23 blockades to synthetic small molecules targeting Janus kinase and tyrosine kinase and phosphodiesterase-4 inhibition. In addition, there are head-to-head clinical trials comparing tumour necrosis factor-α blockade with both IL-17 and IL-23 inhibition. Most of these new therapies have been tested in adults with psoriatic arthritis and have advanced to the phase III stage of drug development or received license for use, suggesting promising signals for efficacy and potentially acceptable safety and tolerability for JPsA. Further translational research in JPsA is required to improve our understanding of the impact of age at onset on treatment efficacy, as well as to provide opportunities for better management of refractory disease and improved long-term outcomes in JPsA, for ultimate patient benefit.

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Authors and Affiliations

  1. Department of Biomedical Sciences, University College London, London, UK

    Sarrah Lokhandwala

  2. University College London Medical School, London, UK

    Jaiden Townsend

  3. Centre for Adolescent Rheumatology, Division of Medicine, University College London, London, UK

    Coziana Ciurtin

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  1. Sarrah Lokhandwala
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Correspondence to Coziana Ciurtin.

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No funding was received for the preparation of this article. Coziana Ciurtin is supported by a grant from the University College London Hospital Biomedical Research Centre, BRC4/III/CC.

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Sarrah Lokhandwala, Jaiden Townsend and Coziana Ciurtin have no conflicts of interest that are directly relevant to the content of this article.

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CC designed the review structure; SL, JT and CC searched the literature and clinical trials databases and selected the relevant information; CC created the figures and tables, and wrote the manuscript; SL, JT and CC reviewed the manuscript; and CC amended the manuscript, tables and figure based on reviewers’ comments. All authors approved the final version.

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Lokhandwala, S., Townsend, J. & Ciurtin, C. Existing and Emerging Targeted Therapies in Juvenile Psoriatic Arthritis: Challenges and Unmet Needs. Pediatr Drugs (2024). https://doi.org/10.1007/s40272-023-00618-2

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