title: 311 nm ultraviolet B-accelerated response of psoriatic lesions in adalimumab-treated patients.
abstract: BACKGROUND
  Treatment with the tumor necrosis factor-alpha antibody adalimumab for 12-16 weeks produces a satisfactory response [i.e., 75% reduction in psoriasis area and severity index (PASI)] in a majority (70-80%) of patients with psoriasis. We asked whether 311 nm ultraviolet B (UVB) can improve therapeutic response of psoriatic lesions to adalimumab.
  
  
  METHODS
  Four patients (age range, 49-67 years) with moderate to severe plaque-type psoriasis were treated with standard dosage of adalimumab. During adalimumab therapy, a randomly selected body half (left or right, excluding the head) was irradiated with 311 nm UVB three times weekly for 6 weeks. Treatment response was monitored weekly in terms of half-body PASI.
  
  
  RESULTS
  311 nm UVB significantly accelerated the therapeutic response during adalimumab treatment. At the start of 311 nm UVB therapy, the mean PASI was 14.8. After 6 weeks of 311 nm UVB therapy, the mean PASI was 2.0 on UV-irradiated body halves and 6.9 on non-irradiated body halves (difference, 4.9; 95% confidence interval, 0.4-9.4; P=0.041; 2-tailed paired t-test). This corresponded to an overall mean PASI reduction from baseline (i.e., adalimumab start) of 86% on UV-irradiated body halves vs. 53% on non-irradiated body halves.
  
  
  CONCLUSIONS
  311 nm UVB may accelerate and improve the clearance of psoriatic lesions in adalimumab-treated patients.
authors: Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Graz, Austria. peter.wolf@meduni.graz.at
authors: Peter
authors: P
authors: Wolf
authors: Angelika
authors: A
authors: Hofer
authors: Wolfgang
authors: W
authors: Weger
authors: Timea
authors: T
authors: Posch-Fabian
authors: Alexandra
authors: A
authors: Gruber-Wackernagel
authors: Franz J
authors: FJ
authors: Legat
mesh_terms: D000068879:Adalimumab; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D012074:Remission Induction; D014466:Ultraviolet Rays; D014467:Ultraviolet Therapy
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068879:Adalimumab