1 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text

Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates

Journal of the American Academy of Dermatology
Volume 61, n° 5
pages 793-798 (novembre 2009)
Doi : 10.1016/j.jaad.2009.04.053
accepted : 22 April 2009
Original Articles

Randomized, double-blind, placebo-controlled evaluation of the efficacy of oral psoralen plus ultraviolet A for the treatment of plaque-type psoriasis using the Psoriasis Area Severity Index score (improvement of 75% or greater) at 12 weeks

S. Priya Sivanesan, MD, MPH a, Shilpa Gattu, BS c, Judith Hong, MD b, Arianne Chavez-Frazier, MD d, Grace D. Bandow, MD e, Farah Malick, MD f, Greg Kricorian, MD g, John Koo, MD b,
a Department of Dermatology, Pittsburgh University, Pittsburgh, Pennsylvania 
b Department of Dermatology, University of California, San Francisco, California 
c University of California, Irvine, California 
d Department of Dermatology, University of Texas Health Science Center, Houston, Texas 
e Albert Einstein College of Medicine, New York, New York 
f Department of Dermatology, Wayne State University, Dearborn, Michigan 
g Amgen Pharmaceuticals, Orange County, California 

Reprint requests: John Koo, MD, 515 Spruce St, San Francisco, CA 94118.

Psoralen plus ultraviolet A (PUVA) for the treatment of psoriasis has never been evaluated using the Psoriasis Area Severity Index (PASI) in a randomized, double-blind, placebo-controlled trial. The lack of such data limits our capacity to estimate PUVA’s efficacy relative to other treatment options that are available today.


The purpose of this study was to evaluate the efficacy of PUVA therapy for patients with plaque-type psoriasis.


This study involved 40 patients with psoriasis; 30 received PUVA and 10 received UVA with placebo. PASI scores were assessed at baseline and every 4 weeks thereafter for 12 weeks.


By nonresponder imputation, 60% (18 of 30) in the PUVA group achieved 75% or more improvement in PASI score after 12 weeks of treatment compared with 0% (0 of 10) in the UVA plus placebo group (P < .0001). Using intent to treat with last observation carried forward analysis, 63% (19 of 30) in the PUVA group achieved 75% or more improvement in PASI score compared with 0% (0 of 10) in the UVA plus placebo group (P < .0001). By per protocol analysis, 86% (18 of 21) in the PUVA group as compared with 0% (0 of 7) in the UVA plus placebo group reached 75% or more improvement in PASI score after 12 weeks (P < .0001).


The study was relatively small with only 40 patients enrolled and 28 patients who completed the protocol. Further studies that involve head-to-head comparison of PUVA with other treatment modalities are needed. Nonresponder imputation, last observation carried forward with intent to treat, and per protocol analyses each have separate advantages and limitations when determining clinical significance.


This study supports the observation that PUVA is a highly efficacious treatment for chronic plaque psoriasis.

The full text of this article is available in PDF format.

Key words : PASI 75, psoriasis, PUVA

Abbreviations used : CI, LOCF, NB, NRI, PASI, PASI 50, PASI 75, PP, PUVA, UV

 Supported by Valeant Pharmaceuticals.
 Disclosure: Dr Koo has been a clinical researcher and/or consultant and/or speaker for Valeant, Allergan, Warner-Chilcott, Amgen, Biogen, Bristol-Myers Squibb, Centacor, Connetics, Elan, Astellas, Galderma, Genentech, GlaxoSmithKlein, Novartis, Roche, and Serono. Ms Gattu is a consultant for Coria Labs. Dr Kricorian was an employee at Amgen Pharmaceuticals. Drs Sivanesan, Hong, Chavez-Frazier, Bandow, and Malick have no conflicts of interest to declare.
 Interim data were presented orally at the American Academy of Dermatology 63rd Annual Meeting, New Orleans, LA, February 18-22, 2005.

© 2009  American Academy of Dermatology, Inc.@@#104156@@
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Article Outline