title: Combination therapy of methotrexate plus NBUVB phototherapy is more effective than methotrexate monotherapy in the treatment of chronic plaque psoriasis.
abstract: BACKGROUND
  The efficacy of methotrexate (MTX) plus narrowband ultraviolet B (NBUVB) phototherapy in treatment of chronic plaque psoriasis has been rarely assessed.
  
  
  OBJECTIVE
  The objective of this study is to compare the efficacy of MTX/NBUVB phototherapy versus MTX monotherapy in treatment of chronic plaque psoriasis.
  
  
  METHODS
  Forty patients with psoriasis were enrolled into the study and classified into group A receiving oral MTX and group B receiving oral MTX plus NBUVB. Onset of improvement was ≤70% of baseline PASI. End point clearance was 90 % reduction in PASI or up to 6 months. Side effects were reported. Follow up for 12 weeks for assessment of relapse was done.
  
  
  RESULTS
  Of 40 patients, 35 completed the study. A higher clearance rate was achieved in patients of group B versus group A (100% versus 83%). A significant difference was reported regarding the onset of improvement and the duration required for clearance (p < 0.001) in favor of the MTX/NBUVB group. Patients in group B had a highly significant lower cumulative dose of MTX than the monotherapy group (p < 0.05). No significant difference as regard side effects and relapse was reported.
  
  
  CONCLUSIONS
  MTX remains the mainstay in the treatment of psoriasis in developing countries and its combination with NBUVB offers a cheap and a beneficial therapeutic option.
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Ali
authors.initials: A
authors.lastname: Soliman
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Eman
authors.initials: E
authors.lastname: Nofal
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nofal
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Fatma
authors.initials: F
authors.lastname: El Desouky
authors.affiliation: a Department of Dermatology and Venereology, Faculty of Medicine , Zagazig University , Zagazig , Egypt.
authors.forename: Maha
authors.initials: M
authors.lastname: Asal
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000628:therapy*; D012008:Recurrence; D014467:Ultraviolet Therapy / Q000379:methods*; D055815:Young Adult
chemical_list: D008727:Methotrexate
keywords: Endpoint clearance; methotrexate; narrowband ultraviolet B; psoriasis