Methotrexate plus narrowband UVB phototherapy versus narrowband UVB phototherapy alone in the treatment of plaque-type psoriasis: A randomized, placebo-controlled study - 09/08/11
, Yaowalak Nateetongrungsak, MD
Reprint requests: Pravit Asawanonda, MD, DSc, Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, Rama 4 Rd, Bangkok 10330 Thailand.Bangkok, Thailand
Abstract |
Background |
Combining phototherapy with topical and oral agents allows clinicians to treat recalcitrant psoriasis with reduced number of treatments and cumulative UV exposures.
Objective |
This study was designed to determine the number of treatments necessary to clear plaque-type psoriasis when narrowband (NB) UVB is administered with methotrexate (MTX) or placebo in a randomized, controlled fashion.
Methods |
MTX (15 mg/wk) or placebo was administered 3 weeks before standard NB UVB phototherapy was started. Treatments with the oral agent and phototherapy were continued until Psoriasis Area and Severity Index scores were reduced to less than 10% of the original scores or 24 weeks. Follow-up was performed until lesional scores returned to 50% of the original ones.
Results |
A total of 24 patients were enrolled and 19 patients completed the study. Kaplan-Meier analysis revealed that the median time to clear psoriasis in the MTX/NB UVB group was 4 weeks, which was significantly less than that for the placebo/NB UVB group.
Limitations |
Our sample size was relatively small (24 patients) with 5 dropouts. In addition, the study was conducted in skin types III to IV, Asian patients. Follow-up was limited to 4 to 6 months after completion of phototherapy.
Conclusion |
MTX pretreatment allows physicians to clear psoriasis in fewer phototherapy sessions than when phototherapy is administered alone.
Le texte complet de cet article est disponible en PDF.Abbreviations used : DLQI, MED, MTX, NB, PASI, PUVA
Plan
| Funding sources: None. Conflicts of interest: None identified. |
Vol 54 - N° 6
P. 1013-1018 - juin 2006 Retour au numéro
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