Bronckers IMGJ, Paller AS, West DP, et al. - Researchers examined if and how use of methotrexate vs biologics affects the psoriasis severity and drug survival (rate and duration of adherence to a specific drug regimen) in pediatric patients with moderate to severe psoriasis. Via performing a retrospective medical records review at 20 European and North American centers, they included 234 pediatric patients (103 boys [44.0%]; 131 girls [56.0%]) with moderate to severe psoriasis in this cohort study. Treatment comprised methotrexate and/or biologics, 163 patients (69.7%) exclusively received methotrexate, 47 patients (20.1%) exclusively received biologics, and 24 children (10.2%) received methotrexate and biologics sequentially. Findings support a possible association of treatment with biologics with a significantly greater reduction in psoriasis severity than methotrexate. In those receiving biologics vs those treated with methotrexate, a Physician Global Assessment status of clear/almost clear was more frequently achieved and 75% or more improvement of the Psoriasis Area and Severity Index rating at 6 months was observed. Furthermore, there was association of biologics with better drug survival rates at 1, 3, and 5 years, with comparable discontinuation rates owing to lack of response.