The effect of maintenance narrow-band ultraviolet B therapy on the duration of remission for psoriasis: a prospective randomized clinical trial.
BACKGROUND
Narrow-band (311 nm) UVB is an effective treatment modality for moderate to severe psoriasis. The effect of maintenance narrow-band UVB on the duration of remission is unknown.


OBJECTIVE
To determine whether maintenance narrow-band UVB affects the duration of remission.


METHODS
After clinically significant improvement [defined as 75% reduction in the initial Psoriasis Area and Severity Index (PASI) = "PASI 75"], patients were randomly assigned to one of two groups, namely maintenance and no maintenance. The first group received 2 months of maintenance therapy; the second group received no further treatment. Both groups were followed up for 1 year.


RESULTS
At the end of 12 weeks, 46 of 50 patients (92%) achieved "PASI 75". Of these 46 patients, 32 had plaque-type psoriasis and 14 had guttate-type psoriasis. The numbers of patients assigned to the maintenance and no maintenance groups were 22 and 24, respectively. At the end of the study, 12 of the 22 patients (55%) in the maintenance group and, by contrast, eight of the 24 patients (33%) in the no maintenance group were still in remission. When the patients in both groups were categorized according to the type of psoriasis, eight of 14 (57%) patients with plaque-type psoriasis in the maintenance group and, by contrast, three of 18 (17%) in the no maintenance group were still in remission. Although numerically significant, life-table analysis indicated no statistically significant difference for the probability of remaining in remission between maintenance and no maintenance groups.


CONCLUSIONS
The results provide some evidence that maintenance narrow-band UVB may achieve longer remission durations for patients with plaque-type psoriasis.
Boztepe
Gonca
G
Department of Dermatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. goncabs@hacettepe.edu
Karaduman
Ayşen
A
Sahin
Sedef
S
Hayran
Murat
M
Kölemen
Fikret
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000628:therapy*; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*