Psoriasis is a distressing chronic inflammatory disease which occurs when the immune system causes skin cells to grow at an accelerated rate.
It is characterized by painful and itchy, red, scaly patches which disfigure the scalp, face, arms, legs, feet and genitals.
One third of psoriasis cases begin in childhood, and the disease is frequently physically and psychologically disabling; in adults it is linked to an increased risk of obesity, type 2 diabetes, liver disease and clinical depression.
Psoriasis affects around 125 million people worldwide.
Etanercept was first approved in 1998 for the treatment of moderate to severe rheumatoid arthritis and has been used in nearly 500,000 patients worldwide.
Researchers from the Feinberg School of Medicine at the University of Chicago conducted a 48-week study designed to assess the safety and effectiveness of etanercept for children.
The drug was tested on a group of 211 psoriasis patients between 4 and 17 years old; of the group, over a 12-week period, 106 were given etanercept and 105 a placebo.
During that time there were no serious adverse events or serious infections and the most common adverse event during the 48-week trial were upper respiratory tract infection, headache, and nasopharyngitis.
In more than half of patients, a three-month course of weekly injections of etanercept, cleared at least three quarters of the red scaly skin patches caused by the condition.
Although etanercept has previously been used with adult victims of psoriasis, this is the first trial which shows it is safe and effective in children.
The results are important because current treatments for children and adolescents with psoriasis are limited and can have serious side-effects.
Lead author Professor Amy Paller, says the children's lives have been changed by being in the study and they are making more progress now than with any other treatment.
Another study published earlier this month also suggested that etanercept could rapidly reduce the symptoms of Alzheimer's disease.
The New England Journal of Medicine.
This panel of 300 markers should be valuable in targeted associated studies that follow up previously implicated candidate genes: by comparing the ancestry of disease cases to healthy controls using data from the panel of 300 markers, researchers can determine whether observed associations are genuine, and not false-positives due to population structure. The panel can also be used to match the ancestry of cases and controls prior to more comprehensive studies.
While the technology should provide a new tool in disease gene mapping studies, the researchers caution that the ability to roughly categorize individuals into populations with a small number of genetic markers is not useful in a clinical setting, nor does it completely eliminate the utility of self-described ethnicity. Although these 300 markers give a reasonable estimate of the major components of genetic ancestry in European Americans, self-described ethnicity can still reflect environmental, social and cultural factors that may not be captured by estimating genetic ancestry, says Dr. Joel Hirschhorn, one of the senior authors of the study, an Associate Professor of Genetics at Children's Hospital Boston and Harvard Medical School, and a Senior Associate Member at the Broad Institute of Harvard and MIT, Because the genetic differences between these populations are very small, the study is most important for helping in gene discovery efforts, which will lead to better understanding of human biology in health and disease, and hopefully improved care for all patients over the long term.
Published simultaneously in PLoS Genetics is an independent study led by Michael Seldin, in which Chao Tian and colleagues also present panels of markers that can be used to correct for population structure in European American disease association studies. A commentary jointly authored by Michael Seldin and Alkes Price on the practical application of the panels developed by the two groups accompanies these articles.
plos/