This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (3)  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in this journal  Topic Collections  • Dermatologic Disorders  • Psoriasis  • Dermatologic Procedures  • Phototherapy  • Alert me on articles by topic  Social Bookmarking   What's this?

Franz J. Legat, MD; Angelika Hofer, MD; Alexandra Wackernagel, MD; Wolfgang Salmhofer, MD; Franz Quehenberger, PhD; Helmut Kerl, MD; Peter Wolf, MD

Arch Dermatol. 2007;143(8):1016-1022.

Objective  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.

Design  Randomized half-body comparison study.

Setting  Ambulatory section of a university hospital photodermatology unit.

Patients  Fourteen patients with moderate to severe psoriasis.

Interventions  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.

Main Outcome Measures  Modified PASI, self-assessed visual analogue scale rating of skin lesions, and self-assessed therapeutic efficacy.

Results  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).

Conclusions  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.

Trial Registration  clinicaltrials.gov Identifier: NCT00407342

Author Affiliations: Research Unit for Photodermatology (Drs Legat, Hofer, Wackernagel, and Wolf), Department of Dermatology (Drs Legat, Hofer, Wackernagel, Salmhofer, Kerl, and Wolf), and Institute for Medical Informatics, Statistics, and Documentation (Dr Quehenberger), Medical University of Graz, Graz, Austria.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

The Role of Narrowband UV-B Plus Alefacept Combination Therapy in the Treatment of Psoriasis
Heidi Jacobe, Laura Winterfield, Flora Kim, Beverley Huet-Adams, and Rachael Cayce
Arch Dermatol. 2008;144(8):1067-1068.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Combination Immunosuppressive Therapies: The Promise and the Peril
Maria R. Robinson, Benjamin D. Korman, and Neil J. Korman
Arch Dermatol. 2007;143(8):1053-1057.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Role of Narrowband UV-B Plus Alefacept Combination Therapy in the Treatment of Psoriasis
Jacobe et al.
Arch Dermatol 2008;144:1067-1068.
FULL TEXT  

The Role of Narrowband UV-B Plus Alefacept Combination Therapy in the Treatment of Psoriasis--Reply
Legat et al.
Arch Dermatol 2008;144:1068-1069.
FULL TEXT