When a systemically administered immunosuppressant is considered for children and adolescents with plaque psoriasis, a first choice is methotrexate, because of its long history of use. A TNF-alpha inhibitor such as etanercept is another option if this treatment fails. In one trial, secuki-numab, an immunosuppressive interleukin-17A inhibitor, seemed to be slightly more effective than etanercept. There is more limited experience with the use of secukinumah than with TNF-alpha inhibitors.
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