S Tzaneva1, A Geroldinger2, H Trattner1, A Tanew1. 1. Department of Dermatology, Division of General Dermatology and Dermato-Oncology, Medical University of Vienna, Vienna, Austria. 2. Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
Abstract
BACKGROUND:Fumaric acid esters (FAE) are safe and effective in patients with moderate-to-severe psoriasis but have a slow onset of action. A short-term combination with narrowband ultraviolet B (NB-UVB) may substantially accelerate the therapeutic response in the induction phase of treatment. OBJECTIVES: To assess the synergistic effect of a 6-week course of NB-UVB phototherapy in addition to FAE in adults with moderate-to-severe plaque psoriasis. METHODS: In this randomized, assessor-masked trial, patients with a Psoriasis Area and Severity Index (PASI) of ≥ 10 and a body surface area affected of ≥ 10 were randomized either to monotherapy with FAE (n = 16) or a combination of FAE with NB-UVB (n = 14). The primary outcome parameter of the study was the mean PASI reduction after 6 weeks of treatment. In addition, the PASI 75 response (≥ 75% improvement from baseline PASI), the Psoriasis Log-based Area and Severity Index (PLASI) and the Dermatology Life Quality Index (DLQI) were assessed as secondary outcome measures. RESULTS: In total, 30 patients (19 men, 11 women; median age 52 years, interquartile range 36-56) were analysed. The mean reduction in PASI after 6 weeks was significantly greater with the combination treatment than with FAE monotherapy (P = 0·016). This was paralleled by a much faster improvement in the DLQI in the combination group than in the FAE-monotherapy group. CONCLUSIONS: Adding a 6-week course of NB-UVB to FAE both accelerates and augments the therapeutic response during the early phase of treatment and increases quality of life in patients with moderate-to-severe plaque psoriasis.
RCT Entities:
BACKGROUND: Fumaric acid esters (FAE) are safe and effective in patients with moderate-to-severe psoriasis but have a slow onset of action. A short-term combination with narrowband ultraviolet B (NB-UVB) may substantially accelerate the therapeutic response in the induction phase of treatment. OBJECTIVES: To assess the synergistic effect of a 6-week course of NB-UVB phototherapy in addition to FAE in adults with moderate-to-severe plaque psoriasis. METHODS: In this randomized, assessor-masked trial, patients with a Psoriasis Area and Severity Index (PASI) of ≥ 10 and a body surface area affected of ≥ 10 were randomized either to monotherapy with FAE (n = 16) or a combination of FAE with NB-UVB (n = 14). The primary outcome parameter of the study was the mean PASI reduction after 6 weeks of treatment. In addition, the PASI 75 response (≥ 75% improvement from baseline PASI), the Psoriasis Log-based Area and Severity Index (PLASI) and the Dermatology Life Quality Index (DLQI) were assessed as secondary outcome measures. RESULTS: In total, 30 patients (19 men, 11 women; median age 52 years, interquartile range 36-56) were analysed. The mean reduction in PASI after 6 weeks was significantly greater with the combination treatment than with FAE monotherapy (P = 0·016). This was paralleled by a much faster improvement in the DLQI in the combination group than in the FAE-monotherapy group. CONCLUSIONS: Adding a 6-week course of NB-UVB to FAE both accelerates and augments the therapeutic response during the early phase of treatment and increases quality of life in patients with moderate-to-severe plaque psoriasis.
Authors: Pau Rosés Gibert; Francisco Javier de la Torre Gomar; Amaia Saenz Aguirre; Javier Gimeno Castillo; Ricardo González Pérez Journal: Psoriasis (Auckl) Date: 2022-06-29
Authors: Larissa Staurengo-Ferrari; Stephanie Badaro-Garcia; Miriam S N Hohmann; Marília F Manchope; Tiago H Zaninelli; Rubia Casagrande; Waldiceu A Verri Journal: Front Pharmacol Date: 2019-01-11 Impact factor: 5.810
Authors: J L W Lambert; S Segaert; P D Ghislain; T Hillary; A Nikkels; F Willaert; J Lambert; R Speeckaert Journal: J Eur Acad Dermatol Venereol Date: 2020-08 Impact factor: 6.166