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Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens.
Br J Dermatol. 2009 Dec; 161(6):1351-6.BJ

Abstract

BACKGROUND

Ultraviolet (UV) B phototherapy is an established treatment option for psoriasis. The optimum dosage regimen still has to be determined. Within-subject comparisons do not take into account the systemic effects of UVB phototherapy. The area of the body treated with low-dose UVB may benefit from the systemic effects of the site treated with a higher UVB dose.

OBJECTIVES

To study the time to clearance in patients with psoriasis in a randomized controlled trial, in which patients were treated with narrowband UVB in either a high-dose or a low-dose regimen.

METHODS

One hundred and nine patients were randomized to a high-dose regimen (group 1) or to a low-dose regimen (group 2). Patients of group 1 and 2 were irradiated with 40% and with 20% incremental doses, respectively, three times weekly. Psoriasis Area and Severity Index (PASI) was measured at baseline and at every 4-week control visit. Treatment was stopped in cases of clearance (90% reduction of baseline PASI).

RESULTS

No significant differences were found in the number of patients achieving clearance. The high-dosage scheme resulted in four fewer treatments with no significant differences in cumulative UV dose, although more protocol adjustments were required in the beginning of the study because of erythema. After 3 months a significantly better clinical outcome was seen after high-dose UVB therapy.

CONCLUSIONS

High-dose UVB therapy results in fewer treatments with better long-term efficacy, with cost-effective benefits for hospital and patients. Therefore UVB phototherapy in a high-dose regimen for psoriasis is recommended. However, a protocol adjustment in the second week with a high-dose regimen is desirable to prevent erythema.

Authors+Show Affiliations

Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. M.Kleinpenning@derma.umcn.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19466961

Citation

Kleinpenning, M M., et al. "Narrowband Ultraviolet B Therapy in Psoriasis: Randomized Double-blind Comparison of High-dose and Low-dose Irradiation Regimens." The British Journal of Dermatology, vol. 161, no. 6, 2009, pp. 1351-6.
Kleinpenning MM, Smits T, Boezeman J, et al. Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens. Br J Dermatol. 2009;161(6):1351-6.
Kleinpenning, M. M., Smits, T., Boezeman, J., van de Kerkhof, P. C., Evers, A. W., & Gerritsen, M. J. (2009). Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens. The British Journal of Dermatology, 161(6), 1351-6. https://doi.org/10.1111/j.1365-2133.2009.09212.x
Kleinpenning MM, et al. Narrowband Ultraviolet B Therapy in Psoriasis: Randomized Double-blind Comparison of High-dose and Low-dose Irradiation Regimens. Br J Dermatol. 2009;161(6):1351-6. PubMed PMID: 19466961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens. AU - Kleinpenning,M M, AU - Smits,T, AU - Boezeman,J, AU - van de Kerkhof,P C M, AU - Evers,A W M, AU - Gerritsen,M J P, Y1 - 2009/04/10/ PY - 2009/5/27/entrez PY - 2009/5/27/pubmed PY - 2010/4/17/medline SP - 1351 EP - 6 JF - The British journal of dermatology JO - Br. J. Dermatol. VL - 161 IS - 6 N2 - BACKGROUND: Ultraviolet (UV) B phototherapy is an established treatment option for psoriasis. The optimum dosage regimen still has to be determined. Within-subject comparisons do not take into account the systemic effects of UVB phototherapy. The area of the body treated with low-dose UVB may benefit from the systemic effects of the site treated with a higher UVB dose. OBJECTIVES: To study the time to clearance in patients with psoriasis in a randomized controlled trial, in which patients were treated with narrowband UVB in either a high-dose or a low-dose regimen. METHODS: One hundred and nine patients were randomized to a high-dose regimen (group 1) or to a low-dose regimen (group 2). Patients of group 1 and 2 were irradiated with 40% and with 20% incremental doses, respectively, three times weekly. Psoriasis Area and Severity Index (PASI) was measured at baseline and at every 4-week control visit. Treatment was stopped in cases of clearance (90% reduction of baseline PASI). RESULTS: No significant differences were found in the number of patients achieving clearance. The high-dosage scheme resulted in four fewer treatments with no significant differences in cumulative UV dose, although more protocol adjustments were required in the beginning of the study because of erythema. After 3 months a significantly better clinical outcome was seen after high-dose UVB therapy. CONCLUSIONS: High-dose UVB therapy results in fewer treatments with better long-term efficacy, with cost-effective benefits for hospital and patients. Therefore UVB phototherapy in a high-dose regimen for psoriasis is recommended. However, a protocol adjustment in the second week with a high-dose regimen is desirable to prevent erythema. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/19466961/Narrowband_ultraviolet_B_therapy_in_psoriasis:_randomized_double_blind_comparison_of_high_dose_and_low_dose_irradiation_regimens_ L2 - https://doi.org/10.1111/j.1365-2133.2009.09212.x DB - PRIME DP - Unbound Medicine ER -