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Legat, FJ; Hofer, A; Wackernagel, A; Salmhofer, W; Quehenberger, F; Kerl, H; Wolf, P.
Narrowband UV-B phototherapy, alefacept, and clearance of psoriasis
ARCH DERMATOL. 2007; 143(8): 1016-1022.
Doi: 10.1001/archderm.143.8.1016
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- Leading authors Med Uni Graz
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Legat Franz
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Wolf Peter
- Co-authors Med Uni Graz
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Gruber-Wackernagel Alexandra
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Hofer Angelika
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Kerl Helmut
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Quehenberger Franz
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Salmhofer Wolfgang
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- Abstract:
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To determine whether the addition of 311-nm narrowband UV-B (NB UV-B) phototherapy accelerates and improves the therapeutic efficacy of alefacept, a biological antipsoriatic drug approved for the treatment of moderate to severe psoriasis.
Randomized half-body comparison study.
Ambulatory section of a university hospital photodermatology unit.
Fourteen patients with moderate to severe psoriasis.
All patients were treated with 7.5 mg of intravenous alefacept once weekly for 12 weeks. Three times each week, a randomly selected body half (left or right) was treated with NB UV-B light until complete remission, defined as a reduction in the Psoriasis Area Severity Index (PASI) to 3 or lower, was achieved on the irradiated body half.
Modified PASI, self-assessed visual analogue scale rating of skin lesions, and self-assessed therapeutic efficacy.
After 12 weeks of treatment, the mean PASIs on UV-irradiated and nonirradiated body halves were significantly reduced by 81% and 62%, respectively (P < .001). From week 3 to week 12, the mean PASI was significantly lower on UV-irradiated body halves than on nonirradiated body halves (P < .001). At week 12, PASI reductions of greater than 75% had been achieved significantly more often on UV-irradiated body halves (86%, 12 of 14) than on nonirradiated body halves (43%, 6 of 14), and complete remission had been achieved significantly more often on UV-irradiated body halves (43%, 6 of 14) than on nonirradiated body halves (0 of 14) (McNemar test P = .03).
In this randomized half-side comparison of alefacept with and without phototherapy for psoriasis, alefacept with NB UV-B phototherapy accelerated and improved the clearance of psoriasis. This suggests a promising future for this combination as antipsoriatic therapy.
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