Long-term application of extracorporeal photochemotherapy in severe atopic dermatitis

Prinz, Bettina; Michelsen, Silke; Pfeiffer, Christiane; Plewig, Gerd

doi:10.1016/s0190-9622(99)70440-8

Cited by 52 publications

(40 citation statements)

References 23 publications

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“…In terms of AD, former studies have shown that photopheresis leads to clinical improvement of the skin, expressed as a reduction of the SCORAD. The studies by Prinz et al [9 ]and Radenhausen et al[ 10, 15] showed a reduction of total IgE, ECP and sIL-2R. Almost 65% of all patients showed a partial or complete remission after 10 cycles of ExP in 2-week intervals.…”

Section: Discussionmentioning

confidence: 97%

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Extracorporeal Photopheresis as a Treatment for Patients with Severe, Refractory Atopic Dermatitis

Sand

Bechara²,

Sand³

et al. 2007

Dermatology

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Introduction: Atopic dermatitis (AD) is a complex disease with a variety of possible treatment regimens. The study objective was to demonstrate that methoxsalen used in conjunction with the Uvar XTS photopheresis system (Therakos, Exton, Pa., USA) is safe and can have a clinical effect on the skin manifestations and the quality of life in patients with severe, refractory AD. Methods: Single-arm, open-label treatment using the Uvar XTS photopheresis system. Seven patients (4 male and 3 female, median age: 47 years) with severe (SCORAD >45) AD of at least 12 months duration who in the preceding 12 months had been refractory to all 3 of the first-line therapies for AD, i.e. topical steroids, topical calcineurin inhibitors and one form of phototherapy (UVA, UVB or PUVA), or to one of the second-line therapies like systemic steroids or cyclosporine were included in the study. Treatment consisted of two extracorporeal photopheresis treatments (ExP) on successive days every 2 weeks for a minimum of 12 weeks to a maximum of 20 weeks. Quality of life assessment was performed with the SF-36 Health Survey and the Functional Assessment of Chronic Illness Therapy FACT-G Survey. Clinical improvement was documented with SCORAD assessment. Results: ExP led to a significant decrease in the SCORAD score from 77.7 after 10 cycles to 55.6. Patients reported that they had begun to notice improvement of their skin conditions after 5 cycles of photopheresis. The FACT-G score showed significant improvement from 64.8 to 72.9 (p < 0.05) and the SF-36 Health Survey showed significant improvement in the emotional well-being subscores (p < 0.05). Conclusions: ExP can have a significant therapeutic effect on the skin and quality of life improvement in a selected group of patients with severe AD who are refractory to conventional forms of therapy. However, larger studies are needed to further evaluate its therapeutic potential.

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Section: Discussionmentioning

confidence: 97%

“…Recently, four open clinical trials have suggested that long-term photopheresis therapy may be safe and effective in severe cases of AD [7,8,9,10]. Photopheresis has also been found to improve laboratory correlates of active AD including hyperimmunoglobulinemia E, and elevated levels of ECP, sIL-2R and soluble E-selectin [10].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Photopheresis as a Treatment for Patients with Severe, Refractory Atopic Dermatitis

Sand

Bechara²,

Sand³

et al. 2007

Dermatology

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show abstract

“…Patients who failed to respond to standard first-and/or second-line therapies showed substantial skin responses to ECP treatment within 6 to 10 cycles. [69][70][71] In the largest study to date, 35 patients with severe, therapy-resistant atopic dermatitis showed a significant overall reduction in Scoring of Atopic Dermatitis score and 23 of 33 patients (73%) were classified as responders to therapy. 72 Furthermore, improvement in the Scoring of Atopic Dermatitis score with ECP has been found to be associated with improvements in some measures of patient quality of life.…”

Section: Ecp In Other Diseasesmentioning

confidence: 99%

Extracorporeal photopheresis: Past, present, and future

Knobler

Barr

Couriel

et al. 2009

Journal of the American Academy of Dermatology

113

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“…153,154 House dust mite reduction. Several studies of the effect of house dust mite reduction were identified in the peer-reviewed literature with conflicting results.…”

Section: Discussionmentioning

confidence: 99%