A randomized study comparing the combination of nbUVB and etanercept to etanercept monotherapy in patients with psoriasis who do not exhibit an excellent response after 12 weeks of etanercept

作者：Lynde Charles W; Gupta Aditya K; Guenther Lyn; Poulin Yves; Levesque Annie; Bissonnette Robert^*

来源：Journal of Dermatological Treatment, 2012, 23(4): 261-267.

DOI：10.3109/09546634.2011.607795

• etanercept
• ultraviolet B
• psoriasis
• tumor necrosis factor antagonist
• phototherapy

Background: There is a lack of data on the combination of phototherapy with etanercept in patients who have not shown an excellent response to etanercept monotherapy. Objectives: To study the combination of narrow-band ultraviolet B (nbUVB) phototherapy with etanercept in patients not demonstrating an improvement of 90% in their Psoriasis Area Severity Index (PASI-90) after 12 weeks of etanercept. Patients and methods: Psoriatic patients not reaching PASI-90 after 12 weeks of etanercept therapy were randomized (1: 1) to receive either etanercept (50 mg once a week) monotherapy or in combination with nbUVB three times weekly for periods of 4 weeks. Results: Seventy-five patients were randomized. Only 21.6% of patients achieved adherence of 80% or more for nbUVB treatments. At week 24, PASI-90 was reached by 16.2% of patients in the etanercept plus nbUVB group when compared with 15.8% of patients in the etanercept monotherapy group (p = 1.000). In patients with high adherence to nbUVB, the PASI-90 at week 16 was 42.9% for etanercept with nbUVB when compared with 3.4% for etanercept monotherapy (p = 0.018). Both treatments were well tolerated. Conclusion: Addition of nbUVB after 12 weeks of etanercept did not significantly improve the clinical response except for a subset of patients with high adherence to nbUVB. Clinical Trials Registration number: NCT00640393.

• 出版日期2012-8