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Study compares treatments for chronic plaque psoriasis
July 18, 2006Oral psoralen - UV-A therapy was found to be more effective than narrowband UV-B therapy in treating patients with chronic plaque psoriasis, according to an article in the July issue of Archives of Dermatology.
It is unclear whether narrowband UV-B (NB-UVB) therapy is as effective as psoralen-UV-A (PUVA) therapy in treating psoriasis, according to background information in the article. PUVA therapy includes the combination of 8-methoxypsoralen medication (taken orally) and exposure to UV-A (long-wave) radiation. NB-UVB involves exposure to UV-B (short-wave) radiation and is thought to be safer than PUVA.
Sami S. Yones, M.Sc., and colleagues from King's College London conducted a randomized, double-blind trial comparing the efficacy of PUVA and NB-UVB therapies in treating chronic plaque psoriasis. Ninety-three patients with moderate-to-severe cases of the disease were recruited to participate in the study. Two hours before receiving UV treatment, patients in the NB-UVB group took a placebo and those in the PUVA group took 10-mg of 8-methoxypsoralen. Patients in both groups attended sessions twice weekly until their skin cleared, up to a maximum of 30 sessions. Patients whose skin cleared were followed up until relapse or for 12 months.
In patients with skin types I through IV (skin more likely to burn), PUVA was more effective than NB-UVB at clearing skin, with respective 84 percent vs. 65 percent clearance. Patients in the PUVA group also achieved skin clearance in a significantly shorter number of treatments, a median of 17 treatments, compared to 28.5 treatments in the NB-UVB group. Nearly half of patients in the PUVA group experienced erythema (redness of the skin) at some point during treatment, compared to less than one-quarter in the NB-UVB group. Six months after skin clearance was achieved, 68 percent of patients in the PUVA group were still clear compared to 35 percent of patients in the NB-UVB group. Overall, patients with skin types V and VI had a lower rate of clearance than those with skin types I through IV (24 percent vs. 75 percent).
The authors write that despite the disadvantages of PUVA treatment (i.e., may cause nausea, has the potential to cause skin cancer, cannot be used during pregnancy), their results "suggest that PUVA compared with NB-UVB tends to clear psoriasis more reliably, with fewer treatments and for longer and should, therefore, still be used in appropriate patients."
JAMA and Archives Journals
In patients with skin types I through IV (skin more likely to burn), PUVA was more effective than NB-UVB at clearing skin, with respective 84 percent vs. 65 percent clearance. Patients in the PUVA group also achieved skin clearance in a significantly shorter number of treatments, a median of 17 treatments, compared to 28.5 treatments in the NB-UVB group. Nearly half of patients in the PUVA group experienced erythema (redness of the skin) at some point during treatment, compared to less than one-quarter in the NB-UVB group. Six months after skin clearance was achieved, 68 percent of patients in the PUVA group were still clear compared to 35 percent of patients in the NB-UVB group. Overall, patients with skin types V and VI had a lower rate of clearance than those with skin types I through IV (24 percent vs. 75 percent).
The authors write that despite the disadvantages of PUVA treatment (i.e., may cause nausea, has the potential to cause skin cancer, cannot be used during pregnancy), their results "suggest that PUVA compared with NB-UVB tends to clear psoriasis more reliably, with fewer treatments and for longer and should, therefore, still be used in appropriate patients."
JAMA and Archives Journals
Psoriasis Current Events and Psoriasis News RSSCurry-cure? Spicing up the effectiveness of a potential disease-fighter
Scientists are reporting development of a nano-size capsule that boosts the body's uptake of curcumin, an ingredient in yellow curry now being evaluated in clinical trials for treatment of several diseases.
Skin-disease patients show brain immunity to faces of disgust
People with psoriasis - an often distressing dermatological condition that causes lesions and red scaly patches on the skin - are less likely to react to looks of disgust by others than people without the condition, new research has found.
Gene variation is 'major genetic determinant of psoriasis'
A specific genetic region that has been increasingly identified as the strongest genetic link to psoriasis has an even more significant role in the chronic skin disease than has been suspected, University of Utah medical researchers show in a new study.
Drug rescues memory lost to Alzheimer's disease
A drug similar to one used in clinical trials for treatment of rheumatoid arthritis and psoriasis has been found to rescue memory in mice exhibiting Alzheimer's symptoms.
Post-transplant combo can replace toxic immune-suppressing drugs in monkeys
Transplant patients rely on drugs to prevent graft rejection, but at the cost of serious side effects.
Psoriasis associated with cardiovascular disease and increased mortality
The skin disease psoriasis is associated with atherosclerosis (a buildup of plaque in the arteries) characterized by an increased prevalence of ischemic heart disease, cerebrovascular disease, peripheral artery disease and an increased risk of death.
Scientists discover new genetic immune disorder in children
Your immune system plays an important function in your health-it protects you against viruses, bacteria, and other toxins that can cause disease.
Study finds unexpected bacterial diversity on human skin
The health of our skin - one of the body's first lines of defense against illness and injury - depends upon the delicate balance between our own cells and the millions of bacteria and other one-celled microbes that live on its surface.
Vitamin D may halt lung function decline in asthma and COPD
Vitamin D may slow the progressive decline in the ability to breathe that can occur in people with asthma as a result of human airway smooth muscle (HASM) proliferation, according to researchers at the University of Pennsylvania.
Home UVB therapy for psoriasis as effective and safe as hospital treatment
For patients with psoriasis, treatment with ultraviolet B (UVB) at home is as effective and as safe as conventional hospital based phototherapy, concludes a study published on bmj.com today.
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