Oral Methoxsalen Photochemotherapy for The Treatment of Psoriasis: a Cooperative Clinical Trial

Melski, John W.; Tanenbaum, Lewis; Parrish, John A.; Fitzpatrick, Thomas B.; Bleich, Howard L.

doi:10.1111/1523-1747.ep12496022

Cited by 476 publications

(113 citation statements)

References 4 publications

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“…The results in 21 adult caucasian patients with widespread plaque psoriasis was most impressive -all the patients cleared completely. Subsequent reports on greater numbers of patients have claimed similar impressive results , Melski et al 1977. Psoriasis cleared in 88% of 1308 patients with extensive psoriasis treated in the American Cooperative Clinical Trial, and failed to clear in only 3%.…”

Section: Institute Of Dermatology St John's Hospitalfor Diseases Of Tmentioning

confidence: 79%

“…Other applications of photochemotherapy Some workers have found photochemotherapy effective in erythrodermic psoriasis (Melski et al 1977) although dosimetry is difficult and improvement slow. Complete clearing of skin lesions and relief of systemic symptoms was achieved in eight patients with generalized pustular psoriasis .…”

Section: Potential Side Effects Mutaqenicity and Neoplastic Potentialmentioning

confidence: 99%

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Photochemotherapy in Psoriasis: A Review

Briffa

Warin

1979

J R Soc Med

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Section: Institute Of Dermatology St John's Hospitalfor Diseases Of Tmentioning

confidence: 79%

Section: Potential Side Effects Mutaqenicity and Neoplastic Potentialmentioning

confidence: 99%

Photochemotherapy in Psoriasis: A Review

Briffa

Warin

1979

J R Soc Med

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“…The ability to tan and propensity to sunburn when unprotected in the sunlight were classified in skin phototypes (Melsky et al, 1977). Skin phototype I subjects declared that they never tanned but (Mantel, 1963).…”

Section: Interviews and Questionnairementioning

confidence: 99%

Melanoma risk and residence in sunny areas

Autier

Doré²,

Gefeller³

et al. 1997

Br J Cancer

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Summary Melanoma risk among subjects from Germany, France and Belgium who had lived for 1 year or more in sunny climates was examined in a one-to-one unmatched case-control study conducted among white subjects 20 years old or more. A total of 412 consecutive patients with melanoma diagnosed from 1 January 1991 onwards, were derived from hospital registers; 445 controls were randomly chosen in the same municipality as the cases. After adjustment for host characteristics, melanoma risk associated with residence in a sunny area was 2.7 (95% Cl: 1.4-5.2), increasing to 4.7 (95% Cl: 1.4-13.5) if subjects sought a suntan when residing in sunny climates, and to 4.3 (95% Cl: 1.7-11.1) if subjects arrived before the age of 10 years in the sunny area. Residence in sunny areas and recreational sun exposure seemed to combine their effects on melanoma risk. Increase in melanoma risk conveyed by deliberate sun exposure during adulthood was highest among subjects who had lived in sunny areas as a child or adolescent and lowest among subjects who had never resided in sunny areas. Our results support conclusions from migrant studies that indicated that childhood is a critical period of either vulnerability to solar radiation or more frequent exposures to melanoma risk factors. They also suggest that moderate sun exposure of an adult who was heavily sun exposed in childhood is associated with a higher melanoma risk than that of high sun exposure of an adult who was sun protected in childhood.

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“…protective glasses. In PUVA therapy, some acute minor effects have been reported, depending on the 8-MOP formulation and dose administered: nausea (3% to 51%) [16][17][18], headache (2%) [16], dizziness (1.5%) [16], pruritus (14% to 71%) [16,17]. A higher and earlier peak concentration has been observed when side effects were present (417 ng ml-' vs 280 ng ml-) [19].…”

Section: Pharmacokinetic Analysis Linearity Analysis Figures 1 and 2 mentioning

confidence: 99%

“…In primates receiving 2-18 mg kg-' 8-MOP orally, only dosedependent emesis, but no organ damage was observed [20]. Chronic surveillance of PUVA therapy has failed to identify any clinically relevant toxicity [16,21]. Also, a prospective study over 5 years examining ophthalmological findings in patients receiving PUVA indicated a small risk of ocular damage in patients who received at least 100 PUVA treatments [22].…”

Section: Pharmacokinetic Analysis Linearity Analysis Figures 1 and 2 mentioning

confidence: 99%

The pharmacokinetics of 8‐methoxypsoralen following i.v. administration in humans [see comments]

Billard

Gambús

Barr

et al. 1995

Brit J Clinical Pharma

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1. 8‐methoxypsoralen (8‐MOP) is a naturally occurring photoreactive substance which, in the presence of u.v. light, forms covalent adducts with pyrimidine bases in nucleic acids. For many years, 8‐MOP has been used in PUVA therapy for treatment of psoriasis. Recently, the drug has been found to inactivate effectively bacteria spiked into platelet concentrates. The purpose of this study was to determine the pharmacokinetics and safety of 8‐MOP administered intravenously in the bactericidal dosage range. 2. Eighteen volunteers were divided into three treatment groups to receive, respectively, 5, 10, and 15 mg 8‐MOP infused over 60 min. Frequent arterial samples were gathered, and the blood and plasma were assayed for 8‐MOP concentration. The pharmacokinetic parameters were determined by moment and compartmental population analysis, the latter performed with the program NONMEM. Haemodynamics, ventilatory pattern, and subjective effects were recorded throughout the study. 3. The intravenously administered 8‐MOP was well tolerated in all individuals, and no acute toxicity was observed. 4. The pharmacokinetics of 8‐MOP were best described by a three‐compartment mammillary model in which the volumes and clearances were proportional to weight. The mean pharmacokinetic parameters for the plasma concentrations were: V1 = 0.045 1 kg‐1, V2 = 0.57 1 kg‐1, V3 = 0.15 1 kg‐1, CL1 (systemic) = 0.010 1 kg‐1 min‐1, CL2 = 0.0067 1 kg‐1 min‐1, CL3 = 0.012 1 kg‐1 min‐1. The mean pharmacokinetic parameters for the blood concentrations were: V1 = 0.061 1 kg‐1, V2 = 1.15 1 kg‐1, V3 = 0.21 1 kg‐1, CL1 (systemic) = 0.015 1 kg‐1 min‐1, CL2 = 0.011 1 kg‐ 1 min‐1 and CL3 = 0.015 1 kg‐1 min‐1. 5. The plasma pharmacokinetic model described the observations with a median absolute error of 17%, and the blood pharmacokinetic model described the observations with a median absolute error of 18%. Analysis of the relative concentration of 8‐MOP between plasma and red blood cells suggested concentration‐ dependent partitioning. 6. The addition of 7.5 mg 8‐MOP to 300 ml platelet concentrate would produce bactericidal concentrations of 25 micrograms ml‐1. Simulations based upon our data show that intravenous administration of 7.5 mg over 60 min would result in systemic concentrations of 8‐MOP similar to those observed with conventional PUVA therapy. We conclude that the extensive safety history established in PUVA therapy will be applicable to this new application of 8‐MOP.

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Oral Methoxsalen Photochemotherapy for The Treatment of Psoriasis: a Cooperative Clinical Trial

Cited by 476 publications

References 4 publications

Photochemotherapy in Psoriasis: A Review

Photochemotherapy in Psoriasis: A Review

Melanoma risk and residence in sunny areas

The pharmacokinetics of 8‐methoxypsoralen following i.v. administration in humans [see comments]

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