Recent studies have compared the use of biologics and methotrexate for the treatment of moderate to severe psoriasis in children. The objective of this study is to assess the real-time, 6-month reduction in psoriasis severity and drug survival of methotrexate vs. biologics in psoriasis in children.

 This is a retrospective medical records review conducted at 20 European and North American centers. The study included 234 pediatric patients with moderate to severe psoriasis who had received at least three months of biologics or methotrexate. The primary outcome of the study was the Psoriasis Area and Severity Index (PASI) score within the first six months of the treatment.

 Out of 234 participants, 163 exclusively received methotrexate, 47 received biologics, and 24 received biologics and methotrexate sequentially. At a 6-month follow-up, 40% of the patients who received methotrexate and 71.4% of patients who received biologics showed a 75% greater improvement in PASI. The drug survival rates for methotrexate after 1,3, and 5 years of use were lower than that of biologics.

 The research concluded that both biologics and methotrexate are associated with improvement in pediatric psoriasis. However, biologics seem to demonstrate a greater reduction in psoriasis severity scores, along with higher drug survival rates.