scholarly journals Narrow band UVB therapy versus tazarotene and narrow band UVB combination therapy in psoriasis: a comparative study

2018 ◽  
Vol 4 (3) ◽  
pp. 429
Author(s):  
Sowmiya R. ◽  
Nithya Gayathri Devi D.
Keyword(s):  
Combination Therapy ◽  
Narrow Band ◽  
Skin Lesions ◽  
Combination Group ◽  
Duration Of Treatment ◽  
Therapeutic Modalities ◽  
Plaque Type ◽  
Narrowband Uvb ◽  
Pasi Score

<p class="abstract"><strong>Background:</strong> Narrow band UVB phototherapy (NBUVB) is considered one of the most effective therapeutic modalities for patients with psoriasis. The long term side effects of narrowband UVB therapy have not been fully documented. There has been a great deal of interest in photo combination therapies that are capable of both reducing cumulative UVB doses and accelerating resolution of skin lesions. The aim of our study was to compare the efficacy and tolerability of NBUVB plus tazarotene combination therapy with NBUVB mono therapy.</p><p class="abstract"><strong>Methods:</strong> Forty patients with chronic plaque type psoriasis were taken up for the study and were randomly divided into two groups of 20 each. One group was treated with thrice-weekly NBUVB phototherapy and the other group received NBUVB phototherapy thrice weekly in addition to topical tazarotene once daily at bed time.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the tazarotene combination group, the reduction in PASI score was more rapid. The duration of treatment and the mean cumulative dose of NBUVB was lesser in the tazarotene combination group. Irritation due to tazarotene was mild and combination of tazarotene with NBUVB was well tolerated.</p><p><strong>Conclusions:</strong> We concluded that combination of tazarotene with NBUVB was well tolerated and was significantly more effective than NBUVB phototherapy alone. </p>

scholarly journals Combination of Excimer Laser and Topical Treatment for Psoriasis: A Systematic Review and Meta-analysis

2019 ◽  
Vol 53 (2) ◽  
Author(s):  
Marie Len A. Camaclang ◽  
Leah Antoinette M. Caro-Chang ◽  
Ma. Lorna F. Frez
Keyword(s):  
Excimer Laser ◽  
Topical Treatment ◽  
Meta Analysis ◽  
Current Evidence ◽  
Combination Group ◽  
Inclusion Criteria ◽  
Plaque Type ◽  
Pasi Score

Objectives. To assess the efficacy and safety of excimer laser in combination with topical standard therapies for treatment of plaque-type psoriasis in comparison to excimer laser alone, standard topical treatment alone, or placebo. Methods. A literature search using Medline, Cochrane and HERDIN was conducted. Data were analyzed using mean difference at 95% confidence interval, with heterogeneity determined by I2 test. Results. Three articles with total of 130 patients fulfilled the inclusion criteria. Topical treatments studied were vitamin analog (calcipotriol), anthralin (dithranol), and steroid (flumethasone pivalate). A subgroup analysis comparing combination therapy and excimer laser alone showed a greater reduction in pooled PASI score reduction (-2.52; 95% CI: -4.28, -0.77) in the combination group after five to six weeks. There was also a significantly greater reduction in cumulative UVB dose (-3.29; 95% CI: -4.29, -2.30) needed for clearing in the combination group. Pigmentation was the commonly observed adverse event in both groups. Conclusions. Excimer laser, in combination with topical treatment, is more effective than excimer laser alone, with significantly lower cumulative UVB dose, but the quality of current evidence is low. Long-term controlled trials are warranted to increase our confidence in the estimates of these outcomes.

Narrowband UVB and cream psoralen-UVA combination therapy for plaque-type psoriasis

2004 ◽  
Vol 50 (5) ◽  
pp. 734-739 ◽  
Author(s):  
Marcella Grundmann-Kollmann ◽  
Ralf Ludwig ◽  
Thomas M Zollner ◽  
Falk Ochsendorf ◽  
Diamant Thaci ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Plaque Type ◽  
Narrowband Uvb

scholarly journals Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Yu Hu ◽  
Lin Lin ◽  
Pangen Cui ◽  
Xu Yao ◽  
Chao Luan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Combined Therapy ◽  
Liver Disorder ◽  
Severe Psoriasis ◽  
Hepatic Toxicity ◽  
Pasi Score ◽  
History Of ◽  
The Mean ◽  
Mean Time

Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated safety and efficacy of combination therapy of infliximab and TGP in treating 13 severe psoriasis patients with liver disorder history.Thirteen patients with severe psoriasis, including 8 men and 5 women, with a mean age of 37.3 ± 12.3 were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean PASI score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5mg/kg and TGP at a dose of 1.8g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 week and 9.6 week, respectively. Conclusion: Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for the patients with liver disorder history.

scholarly journals Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

2019 ◽  
Vol 3 (2) ◽  
pp. 62
Author(s):  
Yu Hu ◽  
Lin Lin ◽  
Pangen Cui ◽  
Xu Yao ◽  
Chao Luan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Combined Therapy ◽  
Severity Index ◽  
Liver Disorder ◽  
Severe Psoriasis ◽  
Total Glucosides Of Paeony ◽  
Pasi Score ◽  
History Of ◽  
The Mean

Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated the safety and efficacy of combination therapy of infliximab and total glucosides of paeony (TGP) in treating 13 severe psoriasis patients with liver disorder history. Patients with severe psoriasis, comprising eight men and five women with a mean age of 37.3 ± 12.3, were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean psoriasis area and severity index (PASI) score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5 mg/kg and TGP at a dose of 1.8 g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 weeks and 9.6 weeks, respectively. Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for patients with liver disorder history.

scholarly journals Modern Aspects of Phototherapy for Atopic Dermatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Sonja Alexandra Grundmann ◽  
Stefan Beissert
Keyword(s):  
Atopic Dermatitis ◽  
Cytokine Production ◽  
Antimicrobial Effect ◽  
Inflammatory Cells ◽  
Extracorporeal Photopheresis ◽  
Therapeutic Modalities ◽  
Narrowband Uvb ◽  
Proven Efficacy ◽  
Atopic Skin

Phototherapy has still great importance in the treatment of atopic dermatitis, though costs, compliance, and long-term risks narrow its relevance. In spite of its long history, up to now, the therapeutic regimes are mostly empirical. Narrowband UVB und UVA1 are the most frequently applied regimens in atopic dermatitis with proven efficacy. However, even for these modalities randomized prospective and controlled studies are still pending. Advances in photoimmunology and molecular biology had demonstrated that phototherapy targets inflammatory cells, alters cytokine production, and has a significant antimicrobial effect within atopic skin. This paper summarizes the current literature on the different regimes of phototherapy and also discusses therapeutic modalities like photochemotherapy and extracorporeal photopheresis. These more complex regimes should be restricted to severe cases of atopic dermatitis, which are refractory to topical treatment.

scholarly journals Defining phenotypes of long-term lithium and valproate response, including combination therapy: a modified application of the Alda scale in patients with bipolar disorders

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Jinyoung Lee ◽  
Ji Hyun Baek ◽  
Dongbin Lee ◽  
Sung Woo Ahn ◽  
So-Yung Yang ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Treatment Response ◽  
Mood Stabilizer ◽  
Term Treatment ◽  
Mood Stabilizers ◽  
Combination Group ◽  
Monotherapy Group ◽  
Clinical Correlates ◽  
Long Term Treatment

Abstract Background When evaluating the long-term treatment response to mood stabilizers using the Alda scale, mood stabilizer combination therapy is typically considered a confounding factor, and patients receiving combination therapy are excluded from the analysis. However, this may result in bias if those under combination therapy are worse treatment responders. This study aims to explore whether the Alda scale is applicable to patients taking lithium and valproate combination therapy. We compared long-term treatment response in patients receiving monotherapy and combination therapy of the two drugs, and investigated clinical correlates of the responses to each drug. Methods The study subjects consisted of 102 patients with bipolar I (BD-I) or bipolar II (BD-II) disorder who had been undergoing maintenance treatment with lithium and/or valproate for more than 2 years at a single specialized bipolar disorder clinic. Long-term treatment response was measured using the Alda scale and compared among the lithium monotherapy group, the valproate monotherapy group, and the mood stabilizer combination group. Clinical correlates of long-term treatment response were evaluated in lithium users and valproate users separately. Results There were no significant differences in terms of baseline illness characteristics among groups. The combination group showed the worst treatment response for all the response measurements applied. This group also had the higher rate of ‘poor responder’ with a statistically significant difference compared to valproate group. Older age at onset and (hypo)manic episode at onset showed significant positive associations with total Alda score in lithium users, while comorbid anxiety disorders, obsessive–compulsive disorder and mixed episode showed significant negative associations in valproate users. Conclusions The combination group had poorer long-term treatment response but did not show distinct clinical characteristics compared to the monotherapy groups. When exploring the long-term effects of mood stabilizers, excluding patients undergoing combination treatment could result in bias because they may represent a poor response group. The long-term treatment responses of lithium and valproate had different clinical correlates.

scholarly journals A study to compare the efficacy of methotrexate alone vs. methotrexate plus pioglitazone in the management of plaque-type psoriasis

2017 ◽  
Vol 6 (4) ◽  
pp. 859
Author(s):  
Shabeer D. ◽  
Basavaraj Bhandare ◽  
Satyanarayana V. ◽  
Pavithra Krishnan
Keyword(s):  
Skin Condition ◽  
Plaque Type ◽  
Significant Difference ◽  
Common Skin ◽  
Pasi Score ◽  
Group A ◽  
Group B ◽  
Novel Drug ◽  
Global Population

Background: Psoriasis is a common skin condition affecting a huge segment of global population. So far, the treatment has been confined to drugs like methotrexate, cyclosporine and oral retinoids which are highly toxic for long term usage and requires a novel drug that is safer.Methods: Cases of plaque type psoriasis are divided into two arms and treated with methotrexate monotherapy in group A and methotrexate plus pioglitazone combination therapy in group B. The outcome of the study is analyzed using PASI score and DLQI scoring systems.Results: Group A and Group B showed significant reduction in the PASI and DLQI scores. Group B was better in terms of efficacy (p<0.05) when compared to Group A. There was no significant difference between the groups in terms of DLQI scoring. Both groups had similar side effect profile.Conclusions: Pioglitazone which acts by sensitizing the cells to insulin poses no risk of hypoglycemia. It is more specific for the treatment of psoriasis as it targets the keratinocytes. Present study suggests a possible role as an adjuvant in the treatment of psoriasis, and could pave way for low dose methotrexate and thereby reducing the potential side effects.

scholarly journals Efficacy of topical Calcipotriol versus combination of topical Calcipotriol plus Betamethasone in the treatment of plaque type psoriasis

2015 ◽  
Vol 10 (1) ◽  
pp. 74-79
Author(s):  
Md Shirajul Islam Khan ◽  
Md Nasir Uddin ◽  
Md Abdul Latif Khan ◽  
Rowshan Ara ◽  
Lubna Khondker
Keyword(s):  
Combination Therapy ◽  
Plaque Psoriasis ◽  
Military Hospital ◽  
P Value ◽  
Base Line ◽  
Plaque Type ◽  
Pasi Score ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: The effectiveness of various topical agents for the treatment of plaque psoriasis is limited and the results are somewhat not satisfactory to some extent. Topical Calcipotriol can be used either monotherapy or combination therapy with betamethasone. This topical agent has “corticosteroid-sparing” benefit and reduction of side effects, duration of treatment and also relapse rates when used as combination therapy for the treatment of psoriasis. Objectives: The present study was conducted to compare the clinical efficacy between the topical Calcipotriol and combined formulation of topical Calcipotriol plus Betamethasone in the treatment of plaque type psoriasis. Materials and Methods: A clinical trial was carried out from January 2011 to Jan 2014 in outpatient department of Dermatology and Venereology, combined military hospital- Dhaka and Jessore Cantonment and Bangabandhu sheikh Mujib Medical University, Dhaka. Patients of plaque type psoriasis were the study population. Consequitive type of non-probability sampling method was followed in this study. Patients were divided into two groups.Group A was treated with topical Calcipotriol (0.005%) ointment and group B with combination of topical Calcipotriol plus Betamethasone ointment. Results: The mean percentage of Psoriasis Area and Severity Index (PASI) reduction after 4th week of treatment was 39.4 and 35.4 in group A and group B (p value >0.05) and after 8th week of 74 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 therapy was 59.6 in-group A and 60.7 in-group B respectively. The mean baseline PASI score was 6.7±4.5 and after 8th week it was 2.0 ±1.4 for group A and mean baseline PASI score was 5.5 ±4.2 and after 8th week it was 2.5±1.4 for group B. There was statistically significant reduction in PASI score from base line after 8th week of treatment in both treatment groups (p < 0.001). After 8th week of treatment moderate response was 22(73.3%) in group A and 18(60%) in group B. Very good response was 4 (13.3%) in group A and 8 (26.7%) in group B and minimal response of treatment occurs equally 4 (13.3%) in group A and group B. Conclusion: In the light of the findings of this study, topical Calcipotriol(0.005%) alone or combination with Betamethasone is individually effective for the treatment of plaque psoriasis but combination therapy is more effective than monotherapy. Therefore it may be recommended that monotherapy can be replaced by combination therapy in treating plaque psoriasis. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22929 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

scholarly journals Efficacy of Narrow - Band UVB Phototherapy versus PUVA Chemophototherapy for Psoriasis in Vietnamese Patients

2019 ◽  
Vol 7 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Thuong Nguyen Van ◽  
Tam Hoang Van ◽  
Phuong Pham Thi Minh ◽  
Hao Nguyen Trong ◽  
Tro Chau Van ◽  
...  
Keyword(s):  
Narrow Band ◽  
Treatment Options ◽  
Severity Index ◽  
Psoriasis Area Severity Index ◽  
Plaque Type ◽  
Pasi Score ◽  
Stopping Treatment ◽  
Uv Dose ◽  
Uvb Phototherapy

BACKGROUND: Psoralen UVA (PUVA) and narrow-band UVB (NBUVB) chemophototherapy are treatment options for psoriasis. AIM: To compare the effectiveness of NBUVB with PUVA in Vietnamese psoriasis patients. METHODS: We conducted a non-randomized trial on 60 patients with plaque-type psoriasis (30 NBUVB, 30 PUVA). Both regimens were thrice-weekly. The extent of lesion was assessed by the Psoriasis Area Severity Index (PASI). Clearance was defined as a ≥ 75% reduction in a follow-up PASI score from baseline. Patients with clearance were followed-up until 6 months after stopping treatment. Relapse was defined as 50% or more of the original extent. RESULTS: The proportion of patients achieving PASI75 was comparable (76.7% in NBUVB versus 80% in PUVA; p > 0.05). Patients in both groups had a similar number of sessions to achieve clearance but patients in the PUVA group exposed to a significantly higher cumulative UV dose. After six months, the relapse rate was higher in the NBUVB group compared with in the PUVA group (p > 0.05). CONCLUSION: Thrice weekly NBUVB is as effective as thrice weekly PUVA in treating psoriasis for Vietnamese patients.

scholarly journals Five-year real-world outcomes of anti-vascular endothelial growth factor monotherapy versus combination therapy for polypoidal choroidal vasculopathy in a Chinese population: a retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Song Xia ◽  
Youxin Chen
Keyword(s):  
Combination Therapy ◽  
Real World ◽  
Combination Group ◽  
Vascular Endothelial ◽  
Visual Outcomes ◽  
Anti Vegf ◽  
The Mean ◽  
Endothelial Growth Factor ◽  
Initial Combination

Abstract Background To evaluate 5-year outcomes of anti-vascular endothelial growth factor (VEGF) monotherapy and combination therapy of anti-VEGF agents and photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV) in a real-world Chinese population. Methods Retrospective study. Fifty-three eyes of 46 patients with subtype 1 and 2 PCV followed up for at least 60 months were grouped into three regimens: anti-VEGF monotherapy, PDT combining with anti-VEGF therapy initially, and PDT combining with deferred anti-VEGF therapy. Main outcome measure was best-corrected visual acuity (BCVA) using logarithm of minimal angle of resolution (logMAR). Results The mean BCVA of eyes with subtype 1 PCV (n = 28) deteriorated from 0.69 logMAR at baseline to 1.25 logMAR at months 60 (P = 0.001), while the mean BCVA of eyes with subtype 2 PCV (n = 25) sustained stable from 0.62 logMAR at baseline to 0.57 at months 60 (P = 0.654). No significant differences of visual outcomes were found between the 3 treatment regimens for subtype 1 PCV. Anti-VEGF monotherapy and initial combination treatment had better visual outcomes in eyes with subtype 2 PCV than deferred combination group during part of follow-up significantly. Initial combination group needed a less number of PDT than deferred combination group (P < 0.001). Conclusions Compared with subtype 1 PCV, subtype 2 PCV has a more favorable visual outcome in real world. All the regimens presented unfavorable visual outcomes for subtype 1 PCV. Anti-VEGF monotherapy and initial combination therapy should be superior to deferred combination therapy in the long-term management of subtype 2 PCV. Prospective randomized studies of larger size are needed to determine the long-term efficacy and safety of various treatment for PCV in real world.

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