A Push for Pediatric Biologics Skips Over Why Clinicians Hesitate

At the Elevate Summer Meeting in San Diego, dermatology PA Eileen Cheever told interviewer Shannon Heaning that immunology has become foundational to how dermatology is practiced. Cheever, who works at Clearview Dermatology in Massachusetts, is a founding advisory board member and medical director of Elevate, giving her comments institutional weight for the conference brand rather than the perspective of an outside attendee.

Cheever's central argument is that clinicians who understand the mechanism of action behind a therapy are better equipped to counsel patients and build trust, particularly with those reluctant to start treatment. She extended that logic to pediatric psoriasis, urging clinicians to advocate more assertively for systemic and biologic therapy. Her framing was blunt: kids only have one childhood, and apprehension about systemics should not be allowed to delay appropriate treatment.

The interview cited two references to support that position: the American Academy of Dermatology's pediatric psoriasis guideline, and a 2025 JAAD Reviews paper by Castelo-Soccio, Kim, Hammers and colleagues on biologics and oral small-molecule inhibitors in pediatric psoriasis care. Beyond those citations, the piece offered no new trial data or specific drug names, functioning more as a distillation of conference messaging than as original reporting.

That messaging arrives with a caveat the interview does not address. FDA-approved biologic options for pediatric psoriasis remain narrow: etanercept for children four and older, and ustekinumab for those twelve and up. Adalimumab and other agents see use, but only off-label. The hesitancy Cheever describes among clinicians may reflect genuine gaps in approved options and supporting evidence as much as psychological discomfort with prescribing biologics to children.

The AAD-NPF joint guidelines, developed with dermatologists, a cardiologist, a rheumatologist and patient representatives, already address biologic use, comorbidities, phototherapy and pediatric-specific management. That existing infrastructure suggests the guidance clinicians need is largely in place, and that the advocacy gap Cheever is describing has more to do with clinician comfort and behavior than with a shortage of direction from professional bodies.

The Castelo-Soccio group's JAAD Reviews paper widens the lens further, treating oral small-molecule inhibitors alongside injectable biologics as part of the modern treatment landscape for pediatric psoriasis. That framing is broader than the injectable-biologic focus of Cheever's comments, and it lines up with a trend playing out elsewhere in Dermatology Times' own coverage this month, including reporting on the oral IL-23 blocker icotrokinra delivering biologic-like efficacy in psoriasis.

Elevate's 2026 summer conference, held July 29 through August 2 at the Gaylord Pacific Resort, also introduced a dedicated JAK Symposium this year, spotlighting JAK inhibitors as another immunologic pathway relevant to the confidence-building argument Cheever makes, though the interview itself never mentions it. The conference is organized by the Elevate Derm Alliance, which Dermatology Times identifies as a strategic alliance partner, a relationship worth keeping in mind when reading interview content generated around the event.

Read against that backdrop, Cheever's call to embrace immunologic understanding and push harder on pediatric biologics captures a real shift in how dermatology clinicians are being asked to think about treatment. The harder story sits underneath it: a field where approved options for children remain limited, oral alternatives are gaining ground, and the conference platform delivering the message has a direct institutional stake in the audience it's addressing.