OBJECTIVE: To study the use of combined photopheresis and psoralen-ultraviolet A irradiation (PUVA) in the treatment of psoriatic arthritis. METHODS: Eight patients with psoriasis and sero-negative arthritis received photopheresis for 12 weeks, followed by photopheresis plus PUVA for another 12 weeks. Clinical and laboratory examinations were performed every 3 months for up to 1 year after therapy. RESULTS: Four patients experienced a marked improvement of joint symptoms that lasted for > or = 12 months post-therapy (74% decrease in the Ritchie articular index; P < 0.01). Prior to therapy, these patients had a higher CD4:CD8 ratio than the poor responders. Only minor laboratory changes occurred. CONCLUSION: A more extensive trial of photopheresis plus PUVA in psoriatic arthritis is warranted.
OBJECTIVE: To study the use of combined photopheresis and psoralen-ultraviolet A irradiation (PUVA) in the treatment of psoriatic arthritis. METHODS: Eight patients with psoriasis and sero-negative arthritis received photopheresis for 12 weeks, followed by photopheresis plus PUVA for another 12 weeks. Clinical and laboratory examinations were performed every 3 months for up to 1 year after therapy. RESULTS: Four patients experienced a marked improvement of joint symptoms that lasted for > or = 12 months post-therapy (74% decrease in the Ritchie articular index; P < 0.01). Prior to therapy, these patients had a higher CD4:CD8 ratio than the poor responders. Only minor laboratory changes occurred. CONCLUSION: A more extensive trial of photopheresis plus PUVA in psoriatic arthritis is warranted.