Fumaric acid esters in combination with a 6‐week course of narrowband ultraviolet B provides an accelerated response compared with fumaric acid esters monotherapy in patients with moderate‐to‐severe plaque psoriasis: a randomized prospective clinical study. (1st March 2018)

• Record Type: Journal Article
• Authors: Tzaneva, S.; Geroldinger, A.; Trattner, H.; Tanew, A.
• Is Part Of: British journal of dermatology. Volume 178:Number 3(2018)
• Page Start: 682
• Page End: 688
• Publication Date: 2018-03-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.16106
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Fumaric acid esters (FAE) are safe and effective in patients with moderate‐to‐severe psoriasis but have a slow onset of action. A short‐term combination with narrowband ultraviolet B (NB‐UVB) may substantially accelerate the therapeutic response in the induction phase of treatment. Objectives: To assess the synergistic effect of a 6‐week course of NB‐UVB phototherapy in addition to FAE in adults with moderate‐to‐severe plaque psoriasis. Methods: In this randomized, assessor‐masked trial, patients with a Psoriasis Area and Severity Index (PASI) of ≥ 10 and a body surface area affected of ≥ 10 were randomized either to monotherapy with FAE ( n = 16) or a combination of FAE with NB‐UVB ( n = 14). The primary outcome parameter of the study was the mean PASI reduction after 6 weeks of treatment. In addition, the PASI 75 response (≥ 75% improvement from baseline PASI), the Psoriasis Log‐based Area and Severity Index (PLASI) and the Dermatology Life Quality Index (DLQI) were assessed as secondary outcome measures. Results: In total, 30 patients (19 men, 11 women; median age 52 years, interquartile range 36–56) were analysed. The mean reduction in PASI after 6 weeks was significantly greater with the combination treatment than with FAE monotherapy ( P = 0·016). This was paralleled by a much faster improvement in the DLQI in the combination group than in the FAE‐monotherapy group. Conclusions: Adding a 6‐week course of NB‐UVB to FAE both accelerates and augments the therapeutic response during the early phase of treatment and increases quality of life in patients with moderate‐to‐severe plaque psoriasis.