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Narrowband UV Therapy Boosts Alefacept (Amevive) Benefit in Psoriasis


GRAZ, Austria -- Alefacept (Amevive) plus phototherapy cleared up psoriasis more quickly than alefacept alone, reported researchers here.

GRAZ, Austria, Aug. 22 -- Alefacept (Amevive) plus phototherapy cleared up psoriasis more quickly than alefacept alone, reported researchers here.

Patients' Mean Psoriasis Area Severity Index score (PASI) was significantly lower on irradiated skin (P<0.001) compared with body areas that were not exposed to narrow band UV, wrote Franz J. Legat, M.D., of the Medical University of Graz, and colleagues in the August issue of Archives of Dermatology.

The trial included 14 patients with moderate to severe psoriasis (baseline PASI score >10).

Each patient received 7.5 mg intravenous alefacept once a week for 12 weeks. Additionally, three times a week half of the patient's body was treated with 311-nm narrowband UV-B phototherapy.

The median number of phototherapy treatments was 21 and the median dose was 28.8 J/cm2 .

Among the findings:

  • After 12 weeks, the mean PASI was 81% lower for irradiated skin and 62% lower for non-irradiated skin (P<0.001).
  • At week 12, PSAI reductions of more than 75% were achieved in 12 of 14 irradiated body halves versus six of 14 nonirradiated body halves.
  • Complete remission was achieved in six of 14 irradiated body halves versus no complete remissions among non-irradiated body halves (P=0.03).

During the 12-week treatment phase, nine patients reported at least one alefacept-related adverse event, with fatigue being the most common side effect.

Previous studies of alefacept have reported therapeutic effects at four to eight weeks after initiation of therapy, but in this study the benefit was reported within two to three weeks.

The authors said, however, that stopping irradiation when the psoriasis was completely cleared "led to a slight increase in PASI until the end of the 12-week alefacept regimen."

The authors concluded that combining alefacept with phototherapy "appears to be a viable approach to the treatment of psoriasis that warrants further study, particularly comparing the two treatments against phototherapy alone."

The findings also suggest the need for trials of other biologics in combination with phototherapy, they wrote.

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