title: Comparative study of the effect of narrowband ultraviolet B phototherapy plus methotrexate vs. narrowband ultraviolet B alone and methotrexate alone in the treatment of plaque-type psoriasis.
abstract: BACKGROUND
  Widespread psoriasis has great effects on life. Effective and rapid response in the treatment is needed. So this study was done to compare the efficacy of combined narrowband ultraviolet-B (NBUVB) plus methotrexate (MTX) versus each one alone in the treatment of psoriasis.
  
  
  METHODS
  A total of 120 patients with widespread plaque-type psoriasis were enrolled, but only 113 patients completed the study. They were divided into three groups randomly, group MN (38) received NBUVB plus MTX, group N (38) received NBUVB alone, and group M (37) received MTX only. End point of treatment (clearance) was 90% reduction in Psoriasis Area and Severity Index (PASI) Score or up to six months, whichever was earlier; follow-up was done for one year.
  
  
  RESULTS
  The mean number of weeks required for achieving clearance was 6.11 ± 1.28 weeks in group MN, 11.42 ± 2.36 weeks in group N, and 20.87 ± 4.21 weeks in group M (P < 0.0001). The mean number of phototherapy sessions was 17.86 ± 3.74 sessions in group MN, and 33.51 ± 6.9 sessions in group N (P < 0.0001). The mean total cumulative dose of NBUVB for achieving clearance was 12.13 ± 4.02 J/cm(2) in group MN, compared with 34.48 ± 13.13 J/cm(2) in group N (P < 0.0001), while the mean total cumulative dose of MTX was 116.04 ± 20.47 mg in group MN compared with 298.63 ± 60.26 mg in group M (P < 0.0001).
  
  
  CONCLUSIONS
  Combination of NBUVB plus MTX provided rapid improvement with less cumulative doses of both therapies compared with each one alone in the treatment of psoriasis.
authors.affiliation: Scientific Council of Dermatology, Iraqi Board for Medical Specializations, Baghdad, Iraq.
authors.forename: Hayder R
authors.initials: HR
authors.lastname: Al-Hamamy
authors.forename: Sabeeh A
authors.initials: SA
authors.lastname: Al-Mashhadani
authors.forename: Ihsan N
authors.initials: IN
authors.lastname: Mustafa
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D008727:Methotrexate