Cutaneous T-cell lymphoma (CTCL) is a chronic condition with low malignancy. International treatment guidelines for CTCL are widely followed in Europe and the USA. Combination therapy with therapeutic agents for CTCL and phototherapy is effective on the basis of European data. The efficacy and safety of combination therapy for Japanese CTCL patients are not established. We investigated the efficacy and safety of combination therapy with photo (chemo)therapy and bexarotene in Japanese CTCL patients. Twenty-five patients received daily oral bexarotene (300 mg/m 2 body surface), followed by bath-psoralen plus ultraviolet (UV)-A (PUVA) or narrowband UV-B. Treatment results were evaluated using the modified Severity-Weighted Assessment Tool (mSWAT) and the Physician Global Assessment of Clinical Condition (PGA) up to week 24. Safety was also assessed. Twenty-four weeks after initiating treatment, the total response rate was 80.0% (mSWAT) and 84.0% (PGA). Response rates did not differ when stratified by disease stage. Number of days (mean AE standard deviation) for time to response, duration of response and time to progression determined by the mSWAT were 20.7 AE 9.62, 117.0 AE 43.0 and 163.6 AE 28.8, respectively. Thelper 2 chemokine levels in patients at stage IIA or more decreased significantly at weeks 12 and 24. All patients experienced adverse events and adverse drug reactions. Serious adverse drug reactions included sepsis, anemia and congestive cardiac insufficiency (n = 1 each). Other adverse drug reactions were of mild to moderate severity. Combination therapy with bexarotene and PUVA was safe and effective in Japanese CTCL patients.

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BackgroundAmong patients with psoriasis, risk factors for developing musculoskeletal manifestations, known as psoriatic arthritis (PsA), are not recognised well.ObjectivesThe aim of this study is to clarify the relationship between severity of skin disease and arthritis.MethodsPsoriasis patients referred from dermatologists for assessment of musculoskeletal manifestations between June 2015 and July 2017 were enrolled. Their age, comorbidity, disease duration and treatment were collected. Presence of inflammatory back pain, sacroiliac joint tenderness or enthesitis were examined. Severity of skin symptoms were evaluated by dermatologists in Psoriasis area and severity index (PASI). Psoriatic arthritis screening and evaluation (PASE) and disease activity score (DAS28 ESR) were also evaluated. PsA was diagnosed by The Classification for Psoriatic Arthritis (CASPAR) criteria assisted with musculoskeletal ultrasound examination.ResultsAmong 107 patients with psoriasis referred from dermatologists during designated period, 63 patients were diagnosed as PsA. These PsA patients were compared with 44 patients who had no arthritis (PsO). Multiple logistic regression analysis showed neither of age, sex, PASI, disease duration, rheumatoid factor (RF), CRP or Matrix Metalloproteinase-3 (MMP3) had no association with presence of PsA (table 1). Among 63 patients with PsA, those using NSAIDs (p=0.028), those with inflammatory back pain (p=0.002) and male patients (p=0.017) had significantly high PASI. PASI significantly correlated with age (Spearman’s correlation coefficient R=−0.303: p=0.016), body height (R=0.301: p=0.019) and weight (R=0.383: p=0.002), but not with DAS28 ESR, MMP3 or disease duration (table 2).Table 1 multiple logistic regression analysis for presence of PsAvariablesOR95% CIP value age0.990.95–1.030.538sex2.130.66–6.900.207PASI0.960.89–1.030.258disease duration0.990.96–1.040.847RF0.990.99–1.010.408CRP2.760.76–10.100.125MMP311.00–1.010.271Abstract AB0957 – Table 2Correlations with PASI in patients with PsA (Spearman’s correlation)variablesRP value age−0.3030.016body height0.3010.019body weight0.3830.002disease duration0.1340.311PASE0.0880.504DAS28 ESR−0.2680.110RF0.1520.273CRP0.2110.105MMP30.1330.310ConclusionsPASI did not associate with presence of arthritis. Furthermore, even DAS28 ESR, reflecting musculoskeletal manifestations, or disease duration did not correlated with PASI among patients with PsA. These indicates severity of skin symptoms is not associated with musculoskeletal manifestations in patients with psoriasis.Disclosure of InterestNone declared