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Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy.
Arch Dermatol. 2006 Jul; 142(7):836-42.AD

Abstract

OBJECTIVE

To compare the efficacy of oral psoralen-UV-A (PUVA) therapy with that of narrowband UV-B (NB-UVB) therapy in patients with chronic plaque psoriasis.

DESIGN

Double-blind randomized study.

SETTING

Phototherapy unit in a university hospital. Patients Ninety-three patients with chronic plaque psoriasis. Interventions Twice-weekly NB-UVB or PUVA therapy, starting at 70% of the minimum phototoxic or erythema dose, with 20% incremental increases. Patients were treated until clearance, up to a maximum of 30 sessions; those with clearance were followed up until relapse or for 12 months.

MAIN OUTCOME MEASURES

Proportion of patients achieving clearance, number of treatments to clearance, and, among those with clearance, the proportion remaining in remission at 6 months.

RESULTS

Patients with skin types V and VI had a lower rate of clearance than those with skin types I through IV (24% vs 75%; P = .001). In patients with skin types I through IV, PUVA was significantly more effective than NB-UVB at achieving clearance (84% vs 65%; P = .02). The median number of treatments to clearance was significantly lower in the PUVA group (17.0 vs 28.5; P<.001). More patients treated with PUVA vs NB-UVB were reported to have erythema at some stage during treatment (49% vs 22%; P = .004), although this difference may have been due to ascertainment bias. Six months after the cessation of therapy, 68% of PUVA-treated patients were still in remission vs 35% of NB-UVB-treated patients. Conclusion Compared with NB-UVB, PUVA achieves clearance in more patients with fewer treatment sessions and results in longer remissions.

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Authors+Show Affiliations

Yones SS
Photobiology Unit, St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, GKT School of Medicine, King's College London, London, England. yones5@yahoo.com
Palmer RA
No affiliation info available
Garibaldinos TT
No affiliation info available
Hawk JL
No affiliation info available

MeSH

Administration, OralAdolescentAdultAgedChronic DiseaseDouble-Blind MethodFemaleFicusinHumansMaleMiddle AgedPUVA TherapyPhotosensitizing AgentsPsoriasisRecurrenceSeverity of Illness IndexTreatment OutcomeUltraviolet RaysUltraviolet Therapy

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16847198

Citation

Yones, Sami S., et al. "Randomized Double-blind Trial of the Treatment of Chronic Plaque Psoriasis: Efficacy of psoralen-UV-A Therapy Vs Narrowband UV-B Therapy." Archives of Dermatology, vol. 142, no. 7, 2006, pp. 836-42.
Yones SS, Palmer RA, Garibaldinos TT, et al. Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy. Arch Dermatol. 2006;142(7):836-42.
Yones, S. S., Palmer, R. A., Garibaldinos, T. T., & Hawk, J. L. (2006). Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy. Archives of Dermatology, 142(7), 836-42.
Yones SS, et al. Randomized Double-blind Trial of the Treatment of Chronic Plaque Psoriasis: Efficacy of psoralen-UV-A Therapy Vs Narrowband UV-B Therapy. Arch Dermatol. 2006;142(7):836-42. PubMed PMID: 16847198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy. AU - Yones,Sami S, AU - Palmer,Roy A, AU - Garibaldinos,Trish T, AU - Hawk,John L M, PY - 2006/7/19/pubmed PY - 2006/8/3/medline PY - 2006/7/19/entrez SP - 836 EP - 42 JF - Archives of dermatology JO - Arch Dermatol VL - 142 IS - 7 N2 - OBJECTIVE: To compare the efficacy of oral psoralen-UV-A (PUVA) therapy with that of narrowband UV-B (NB-UVB) therapy in patients with chronic plaque psoriasis. DESIGN: Double-blind randomized study. SETTING: Phototherapy unit in a university hospital. Patients Ninety-three patients with chronic plaque psoriasis. Interventions Twice-weekly NB-UVB or PUVA therapy, starting at 70% of the minimum phototoxic or erythema dose, with 20% incremental increases. Patients were treated until clearance, up to a maximum of 30 sessions; those with clearance were followed up until relapse or for 12 months. MAIN OUTCOME MEASURES: Proportion of patients achieving clearance, number of treatments to clearance, and, among those with clearance, the proportion remaining in remission at 6 months. RESULTS: Patients with skin types V and VI had a lower rate of clearance than those with skin types I through IV (24% vs 75%; P = .001). In patients with skin types I through IV, PUVA was significantly more effective than NB-UVB at achieving clearance (84% vs 65%; P = .02). The median number of treatments to clearance was significantly lower in the PUVA group (17.0 vs 28.5; P<.001). More patients treated with PUVA vs NB-UVB were reported to have erythema at some stage during treatment (49% vs 22%; P = .004), although this difference may have been due to ascertainment bias. Six months after the cessation of therapy, 68% of PUVA-treated patients were still in remission vs 35% of NB-UVB-treated patients. Conclusion Compared with NB-UVB, PUVA achieves clearance in more patients with fewer treatment sessions and results in longer remissions. SN - 0003-987X UR - https://www.unboundmedicine.com/medline/citation/16847198/Randomized_double_blind_trial_of_the_treatment_of_chronic_plaque_psoriasis:_efficacy_of_psoralen_UV_A_therapy_vs_narrowband_UV_B_therapy_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/archderm.142.7.836 DB - PRIME DP - Unbound Medicine ER -