Older Adults Poorly Represented in Trials for Plaque Psoriasis Treatment

A study published in the Journal of the American Academy of Dermatology found poor representation of older adults is typical in randomized controlled trials (RCTs) of systemic treatment for plaque psoriasis, reports Healio . The researchers performed a systematic literature search of PubMed/MEDLINE, Embase, and CENTRAL databases for such RCTs over 15 years, evaluating for direct exclusion based on age limits and indirect exclusion based on other criteria. The review covered 162 trials, with 54 showing an upper age limit of 55 to 85 years. Two trials had no exclusion criteria, and 106 RCTs had exclusion criteria but no upper age limit. Still, 96 of those trials had some form of exclusion criteria that might disproportionately impact older adults. The most commonly cited exclusion criteria were serious concurrent infection, malignancy, hematologic disease, immunodeficiency, and hepatic or renal impairment. "Given the increasingly aging world population, the need for guidance in treating older adults with psoriasis is likely to increase over time," the researchers concluded. "In order to be able to make better and more thoughtful management choices in older adults in the future, more clinical research is needed regarding the efficacy and safety of systemic therapy in older people with psoriasis."