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Study Compares Psoriasis Treatments

Drug plus UV-A radiation comes out on top, researchers say

MONDAY, July 17, 2006 (HealthDay News) -- In a head-to-head trial of two treatments for chronic plaque psoriasis, Psoralen-UV-A (PUVA) therapy proved more effective than narrowband UV-B (NB-UVB) in treating the illness, U.K. researchers report.

PUVA is a combination of 8-methoxypsoralen medication (taken orally) plus exposure to UV-A (long-wave) radiation. NB-UVB involves exposure to UV-B (short-wave radiation).

This study included 93 people with moderate-to-severe chronic plaque psoriasis. They were divided into two groups that received either PUVA or NB-UVB. Both groups were treated twice a week, either until their skin cleared or up to a maximum of 30 sessions.

Patients whose skin cleared during the study were followed up until relapse, or for 12 months, whichever came first.

In patients with skin types I through IV (skin that's more likely to burn), PUVA was 84 percent effective at clearing skin, compared to 65 percent for NB-UVB. Patients receiving PUVA required a median of 17 treatments before their skin cleared, compared with 28.5 treatments for those receiving NB-UVB.

Six months after skin clearance, 68 percent of patients in the PUVA group were still clear, compared to 35 percent of those in the NB-UVB group.

Overall, people with skin types V and VI had a 24 percent rate of clearance, compared to 75 percent for those with skin types I through IV.

However, the study also found that nearly half the patients receiving PUVA suffered redness of the skin (erythema) during their treatment, compared to less than 25 percent of those in the NB-UVB group.

Even though PUVA appears more effective, it does has a number of disadvantages, the researchers said. It may cause nausea, it cannot be used during pregnancy, and it has the potential to cause skin cancer.

Despite those concerns, the study authors noted that PUVA, "tends to clear psoriasis more reliably, with fewer treatments and for longer, and should, therefore, still be used in appropriate patients."

The findings were reported in the July Archives of Dermatology.

More information

The American Academy of Dermatology has more about psoriasis.

SOURCE: JAMA/Archives journals, news release, July 17, 2006
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