Utilization of narrow-band ultraviolet light B therapy and etanercept for the treatment of psoriasis (UNITE): efficacy, safety, and patient-reported outcomes.
BACKGROUND
Moderate to severe psoriasis is a significant inflammatory disease that frequently requires systemic therapies to effectively treat the underlying disorder. Etanercept and narrow-band ultraviolet light B (NB-UVB) are widely used to treat this disease.


OBJECTIVE
To evaluate the effectiveness, tolerability, and patient-reported outcomes of combination etanercept plus NB-UVB phototherapy in moderate to severe plaque psoriasis.


METHODS
This 12-week, single-arm, open-label study evaluated the combination of etanercept 50 mg twice weekly and NB-UVB thrice weekly in 86 patients. The primary outcome measure was > or =75% improvement from baseline in the Psoriasis Area and Severity Index (PASI 75). Other measures included PASI 90, PASI 100, and the Dermatology Life Quality Index (DLQI).


RESULTS
At week 12, 26.0% achieved PASI 100, 58.1% achieved PASI 90, and 84.9% of patients achieved PASI 75. Mean improvement from baseline in DLQI was 84.4%. No unexpected, untoward adverse events were noted.


CONCLUSIONS
A 12-week course of etanercept plus NB-UVB phototherapy was well tolerated and produced clinically meaningful improvements in signs and symptoms of moderate to severe plaque psoriasis and in patient-reported outcomes. Further investigation of the safety and efficacy of the use of such combination for this indication in controlled clinical trials would be of interest.
Kircik
Leon
L
Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA. wedoderm@bellsouth.net
Bagel
Jerry
J
Korman
Neil
N
Menter
Alan
A
Elmets
Craig A
CA
Koo
John
J
Yang
Yu-Ching
YC
Chiou
Chiun-Fang
CF
Dann
Frank
F
Stevens
Seth R
SR
D000328:Adult; D003131:Combined Modality Therapy; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage* / Q000009:adverse effects; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012044:Regression Analysis; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept