Combination therapy of methotrexate plus NBUVB phototherapy is more effective than methotrexate monotherapy in the treatment of chronic plaque psoriasis

Soliman, Ali M.; Nofal, Eman; Nofal, Ahmad; Desouky, Fatma El; Asal, M

doi:10.3109/09546634.2015.1034069

Cited by 17 publications

(11 citation statements)

References 13 publications

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“…Adverse effects of both treatment groups are consistent with the previous study where the same treatment protocols were used to evaluate their efficacy in chronic plaque‐type psoriasis 7 …”

Section: Discussionsupporting

confidence: 87%

“…Baseline characteristics of the patients in both groups Adverse effects of both treatment groups are consistent with the previous study where the same treatment protocols were used to evaluate their efficacy in chronic plaque-type psoriasis. 7 The results of this study are limited by its single-center open-label trial, small sample size, lack of long-term follow-up, and assessment of efficacy only using m-PPPASI scores.…”

Section: Discussionmentioning

confidence: 98%

“…Treatment is selected based on the severity and location of the psoriasis, as well as medication adverse effects, patient characteristics (eg, age, sex, and comorbid condition) and financial constraints 2 . There were few studies where methotrexate (MTX) plus narrowband ultraviolet light B (NBUV‐B) vs NBUV‐B alone and MTX monotherapy were compared for chronic plaque type of psoriasis and PPP 3‐8 . Little information exists regarding the management of PPP in Bangladeshi Caucasians with skin phototype IV.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of oral methotrexate (MTX) monotherapy vs oral MTX plus narrowband ultraviolet light B phototherapy in palmoplantar psoriasis

Ara

Mowla

Alam³

et al. 2020

Dermatologic Therapy

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Palmoplantar psoriasis (PPP) is a chronic, inflammatory dermatosis of the palms and/or soles with significant morbidity. It is notoriously difficult to treat and unresponsive to traditional topical agents. We aim to compare the effect of oral methotrexate (MTX) monotherapy vs MTX plus narrowband ultraviolet light B (NB‐UVB) in the treatment of recalcitrant PPP. This was a comparative clinical trial involving 90 patients of PPP. Eligible patients were randomly assigned to one of the two treatment groups. We aim patients in group A received 10 mg oral MTX weekly, and patients in group B received oral MTX 10 mg weekly and NB‐UVB sessions twice weekly for 12 weeks. There was a statistically significant difference in reduction of modified PPP Area Severity Index (m‐PPPASI) of patients in MTX plus NB‐UVB at week 12. The mean m‐PPPASI at week 12 was 3.66 ± 2.11 in MTX plus NB‐UVB group and 6.51 ± 2.04 in MTX only group (P < .001). Marked improvement (m‐PPPASI 75) was achieved in 20 (44.44%) patients in MTX plus NB‐UVB group compared with 6 (13.3%) in MTX monotherapy group (P < .001). Combination of MTX and NB‐UVB phototherapy helps to attain a better clinical response (reduction in m‐PPPASI score) than MTX monotherapy in the treatment of recalcitrant PPP.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Efficacy of oral methotrexate (MTX) monotherapy vs oral MTX plus narrowband ultraviolet light B phototherapy in palmoplantar psoriasis

Ara

Mowla

Alam³

et al. 2020

Dermatologic Therapy

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“…In conclusion, both groups had treatment efficacy, but NBUVB and MTX group were better than the control group, p < 0.05. Combined NBUVB and methotrexate were more promising than methotrexate alone in psoriasis treatment, but recurrence after 3 months, 6 months of 2 groups was not different [4]. Our study outcome was similar to Soliman et al research, demonstrating that methotrexate and NBUVB are superior to methotrexate alone.…”

Section: Discussionsupporting

confidence: 86%

Successful Psoriasis Treatment Using NB-UVB with Methotrexate: The Vietnamese Experience

Van¹,

Diem²,

Thi³

et al. 2019

Open Access Maced J Med Sci

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AIM:To compare the effectiveness of narrowband ultraviolet B (NBUVB) and oral methotrexate (MTX) to oral MTX alone in Vietnamese psoriasis patients, from May 2016 to May 2018.METHODS:We conducted a non-randomized trial on 70 patients with plaque-type psoriasis of moderate to severe. Thirty-five patients apply NBUVB once/day in 5 days/week for 4 weeks plus oral MTX 7.5 mg/week and 35 patients oral MTX 7.5 mg/week and both two groups treatment for 3 months. The extent of the lesion was assessed by the Psoriasis Area and Severity Index (PASI).RESULTS:The proportion of decreasing PASI was comparable (68.49% in NBUVB and MTX versus 57.62% in MTX alone); p < 0.05. Inside, good 28.58%, moderate 68.57% and poor 2.85% in NBUVB and MTX better than good 2.85%, moderate 71.4% and poor 25.72% in MTX alone; p < 0.05. The recurrence rate after 24 months of the NBUVB and MTX group (42.9%) was lower than the MTX alone group (71.4%); p < 0.05.CONCLUSION:NBUVB and oral MTX have affected treatment with chronic plaque psoriasis better than oral MTX alone.

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“…Combining methotrexate with phototherapy is thought to be associated with lower risk than other immunosuppressants and has been used for psoriasis treatment. 59 Factors to consider when choosing a systemic agent Each patient's situation is unique, and several factors influence the discussion between patient/ caregiver and physician that leads to therapeutic decision making. 60 These include existent comorbidities and results of baseline investigations; patient age; anticipation of pregnancy and family planning issues for both male and female patients; and the patient's previous clinical experience, including with systemic agents.…”

Section: Infection Should Be Sought and Treated As Appropriatementioning

confidence: 99%

When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council

Simpson

Bruin‐Weller

Flohr

et al. 2017

Journal of the American Academy of Dermatology

177

202

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Combination therapy of methotrexate plus NBUVB phototherapy is more effective than methotrexate monotherapy in the treatment of chronic plaque psoriasis

Abstract: MTX remains the mainstay in the treatment of psoriasis in developing countries and its combination with NBUVB offers a cheap and a beneficial therapeutic option.

Cited by 17 publications

References 13 publications

Efficacy of oral methotrexate (MTX) monotherapy vs oral MTX plus narrowband ultraviolet light B phototherapy in palmoplantar psoriasis

Efficacy of oral methotrexate (MTX) monotherapy vs oral MTX plus narrowband ultraviolet light B phototherapy in palmoplantar psoriasis

Successful Psoriasis Treatment Using NB-UVB with Methotrexate: The Vietnamese Experience

When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council

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