A short cycle of narrow-band UVB phototherapy in the early phase of long-term efalizumab can provide a quicker remission of moderate and severe psoriasis: a pilot study.
BACKGROUND
Efalizumab, albeit highly efficient in psoriasis treatment, displays a slower rate of clearance when compared to anti-tumor-necrosis-factor-alpha drugs. It has been suggested that a combination of treatments might accelerate efalizumab response.


OBJECTIVE
To determine whether the combination of narrow-band ultraviolet B (NB-UVB) phototherapy and efalizumab could improve the therapeutic efficacy of efalizumab alone in moderate to severe psoriasis. methods: Ten patients underwent a treatment cycle with a whole-body NB-UVB phototherapy (3 sessions a week) during the first 4 weeks of a 6-month treatment with efalizumab at 1 mg/kg body weight/week. In addition, one of two similar plaques, selected for each patient, was shielded during phototherapy.


RESULTS
A statistically significant reduction of the psoriasis severity index score was observed at 4 weeks in the irradiated plaque. A Psoriasis Area and Severity Index 75 was achieved by 70% of patients by week 12 as compared to 22-39% reported in the literature.


CONCLUSIONS
This pilot study indicates that the combination with NB-UVB improves the efficacy of efalizumab monotherapy in the treatment of moderate to severe psoriasis.
Zane
Cristina
C
Department of Dermatology, University of Brescia, Spedali Civili Hospital, Brescia IT-25123, Italy.
Capezzera
Rossana
R
Venturini
Marina
M
Sala
Raffaella
R
Facchinetti
Elena
E
Pedretti
Alessandra
A
Calzavara-Pinton
Piergiacomo
P
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D018845:CD11 Antigens; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011565:Psoriasis / Q000473:pathology / Q000628:therapy*; D014467:Ultraviolet Therapy
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018845:CD11 Antigens; C472181:efalizumab