title: A randomized study comparing the combination of nbUVB and etanercept to etanercept monotherapy in patients with psoriasis who do not exhibit an excellent response after 12 weeks of etanercept.
abstract: BACKGROUND
  There is a lack of data on the combination of phototherapy with etanercept in patients who have not shown an excellent response to etanercept monotherapy.
  
  
  OBJECTIVE
  To study the combination of narrow-band ultraviolet B (nbUVB) phototherapy with etanercept in patients not demonstrating an improvement of 90% in their Psoriasis Area Severity Index (PASI-90) after 12 weeks of etanercept.
  
  
  METHODS
  Psoriatic patients not reaching PASI-90 after 12 weeks of etanercept therapy were randomized (1:1) to receive either etanercept (50 mg once a week) monotherapy or in combination with nbUVB three times weekly for periods of 4 weeks.
  
  
  RESULTS
  Seventy-five patients were randomized. Only 21.6% of patients achieved adherence of 80% or more for nbUVB treatments. At week 24, PASI-90 was reached by 16.2% of patients in the etanercept plus nbUVB group when compared with 15.8% of patients in the etanercept monotherapy group (p = 1.000). In patients with high adherence to nbUVB, the PASI-90 at week 16 was 42.9% for etanercept with nbUVB when compared with 3.4% for etanercept monotherapy (p = 0.018). Both treatments were well tolerated.
  
  
  CONCLUSIONS
  Addition of nbUVB after 12 weeks of etanercept did not significantly improve the clinical response except for a subset of patients with high adherence to nbUVB.
  
  
  BACKGROUND
  NCT00640393.
authors.affiliation: Lynderm Research, Markham, ON, Canada.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Lynde
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Lyn
authors.initials: L
authors.lastname: Guenther
authors.forename: Yves
authors.initials: Y
authors.lastname: Poulin
authors.forename: Annie
authors.initials: A
authors.lastname: Levesque
authors.forename: Robert
authors.initials: R
authors.lastname: Bissonnette
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014467:Ultraviolet Therapy / Q000379:methods*; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept