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. Conclusion: This pilot study indicates that the combination with NB-UVB improves the efficacy of efalizumab monotherapy in the treatment of moderate to severe psoriasis. Copyright (C) 2009 S. Karger AG, Basel