Pharmacology and therapeutics
Comparative study of the effect of narrowband ultraviolet B phototherapy plus methotrexate vs. narrowband ultraviolet B alone and methotrexate alone in the treatment of plaque-type psoriasis Hayder R. Al-Hamamy1, MBCHB, DDV, PhD, CABD, Sabeeh A. Al-Mashhadani2, MBCHB, 3 MSC, and Ihsan N. Mustafa , MBCHB, FIBMS
1 Scientific Council of Dermatology, Iraqi Board for Medical Specializations, 2 Department of Dermatology and Venereology, College of Medicine, University of Baghdad, and 3Department of Dermatology and Venereology, College of Medicine, AL-Nahrain University, Baghdad, Iraq
Correspondence Dr. Ihsan N. Mustafa department of dermatology & venereology AL-Nahrain college of medicine. Baghdad Iraq E-mail: [email protected] The research was conducted in Baghdad teaching hospital.
Abstract Background Widespread psoriasis has great effects on life. Effective and rapid response in the treatment is needed. So this study was done to compare the efficacy of combined narrowband ultraviolet-B (NBUVB) plus methotrexate (MTX) versus each one alone in the treatment of psoriasis. Methods A total of 120 patients with widespread plaque-type psoriasis were enrolled, but only 113 patients completed the study. They were divided into three groups randomly, group MN (38) received NBUVB plus MTX, group N (38) received NBUVB alone, and group M (37) received MTX only. End point of treatment (clearance) was 90% reduction in Psoriasis Area and Severity Index (PASI) Score or up to six months, whichever was earlier; follow-up was done for one year. Results
The
mean
number
of
weeks
required
for
achieving
clearance
was
6.11 1.28 weeks in group MN, 11.42 2.36 weeks in group N, and 20.87 4.21 weeks in group M (P < 0.0001). The mean number of phototherapy sessions was 17.86 3.74 sessions in group MN, and 33.51 6.9 sessions in group N (P < 0.0001). The mean total cumulative dose of NBUVB for achieving clearance was 12.13 4.02 J/cm2 in group MN, compared with 34.48 13.13 J/cm2 in group N
Conflicts of interest: None.
(P < 0.0001), while the mean total cumulative dose of MTX was 116.04 20.47 mg in group MN compared with 298.63 60.26 mg in group M (P < 0.0001). Conclusions Combination of NBUVB plus MTX provided rapid improvement with less cumulative doses of both therapies compared with each one alone in the treatment of psoriasis.
Introduction Psoriasis is a common skin disease with an estimated prevalence between 2 and 3% of the world’s population.1 While the disease is seldom life-threatening, the psychosocial burden for patients is often considerable, and impairment of quality of life may be significant.2 In addition, psoriasis also carries a substantial economic burden.3 The severity of psoriasis is defined not only by extent of body surface area involvement (
Comparative study of the effect of narrowband ultraviolet B phototherapy plus methotrexate vs. narrowband ultraviolet B alone and methotrexate alone in the treatment of plaque-type psoriasis Hayder R. Al-Hamamy1, MBCHB, DDV, PhD, CABD, Sabeeh A. Al-Mashhadani2, MBCHB, 3 MSC, and Ihsan N. Mustafa , MBCHB, FIBMS
1 Scientific Council of Dermatology, Iraqi Board for Medical Specializations, 2 Department of Dermatology and Venereology, College of Medicine, University of Baghdad, and 3Department of Dermatology and Venereology, College of Medicine, AL-Nahrain University, Baghdad, Iraq
Correspondence Dr. Ihsan N. Mustafa department of dermatology & venereology AL-Nahrain college of medicine. Baghdad Iraq E-mail: [email protected] The research was conducted in Baghdad teaching hospital.
Abstract Background Widespread psoriasis has great effects on life. Effective and rapid response in the treatment is needed. So this study was done to compare the efficacy of combined narrowband ultraviolet-B (NBUVB) plus methotrexate (MTX) versus each one alone in the treatment of psoriasis. Methods A total of 120 patients with widespread plaque-type psoriasis were enrolled, but only 113 patients completed the study. They were divided into three groups randomly, group MN (38) received NBUVB plus MTX, group N (38) received NBUVB alone, and group M (37) received MTX only. End point of treatment (clearance) was 90% reduction in Psoriasis Area and Severity Index (PASI) Score or up to six months, whichever was earlier; follow-up was done for one year. Results
The
mean
number
of
weeks
required
for
achieving
clearance
was
6.11 1.28 weeks in group MN, 11.42 2.36 weeks in group N, and 20.87 4.21 weeks in group M (P < 0.0001). The mean number of phototherapy sessions was 17.86 3.74 sessions in group MN, and 33.51 6.9 sessions in group N (P < 0.0001). The mean total cumulative dose of NBUVB for achieving clearance was 12.13 4.02 J/cm2 in group MN, compared with 34.48 13.13 J/cm2 in group N
Conflicts of interest: None.
(P < 0.0001), while the mean total cumulative dose of MTX was 116.04 20.47 mg in group MN compared with 298.63 60.26 mg in group M (P < 0.0001). Conclusions Combination of NBUVB plus MTX provided rapid improvement with less cumulative doses of both therapies compared with each one alone in the treatment of psoriasis.
Introduction Psoriasis is a common skin disease with an estimated prevalence between 2 and 3% of the world’s population.1 While the disease is seldom life-threatening, the psychosocial burden for patients is often considerable, and impairment of quality of life may be significant.2 In addition, psoriasis also carries a substantial economic burden.3 The severity of psoriasis is defined not only by extent of body surface area involvement (
