A single-blind study comparing acitretin and narrow-band UVB with the combination of placebo and narrow-band UVB in the treatment of plaque-type psoriasis

G�rel, G�lhan; Sara�o�lu, Zeynep Nurhan; Koku Aksu, Ay�e Esra

A single-blind study comparing acitretin and narrow-band UVB with the combination of placebo and narrow-band UVB in the treatment of plaque-type psoriasis [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2015; 49(1): 2-6 | DOI: 10.4274/turkderm.54771

A single-blind study comparing acitretin and narrow-band UVB with the combination of placebo and narrow-band UVB in the treatment of plaque-type psoriasis

G�lhan G�rel¹, Zeynep Nurhan Sara�o�lu¹, Ay�e Esra Koku Aksu²
¹Eski�ehir Osmangazi University School Of Medicine Department Of Dermatology And Venerology
²�stanbul Training And Research Hospital Dermatology Clinic

Background and Design: In this study, we aimed to compare effects of acitretin and narrow-band UVB with the combination of placebo and narrow-band UVB on the treatment of plaque type psoriasis.
Material and Method: A total of 50 patients with plaque type psoriasis in whom more than 10% of body surface area affected were divided into 2 groups of 25 subjects. The first group of patients was treated with narrow-band UVB and 25 mg/day oral acitretin and the second group of patients was treated with narrow-band UVB and placebo. Patients were evaluated every 2 weeks during 12 weeks period. In each patient visit, PASI was evaluated by an independent observer. SAPASI which is assessed by the patient was calculated. Pre- and post-treatment quality of life was evaluated by Skindex 29.
Results: The study included a total of 50 patients (25 female, 25 male) aged 18-71 years. When PASI and SAPASI changes were evaluated, there were significant differences between two groups at second week (p<0.05). Also, there were significant differences in terms of PASI and SAPASI values at 4 th, 6 th, 8 th, 10 th and 12 th weeks of two groups (p<0.001). Clinical response was found to be better in patients treated with the combination of acitretin and narrow-band UVB compared to those treated with narrow-band UVB therapy alone. Both treatment protocols were found to lead to significant improvement in the symptoms, function and emotional scales scores of Skindex 29.
Conclusion: Because of short and better response of combination treatment clinicians may prefer combination treatment for patients who have psoriasis vulgaris and are suitable for taking narrow-band UVB and acitretin. Psoriasis is considered a kind of disease that has significant impacts on quality of life.

Keywords: Psoriasis, narrow-band UVB, acitretin, Skindex 29

Plak tip psoriasis tedavisinde asitretin ve dar bant UVB ile plasebo ve dar bant UVB kombinasyonunun kar��la�t�r�ld�� tek k�r �al��ma

G�lhan G�rel¹, Zeynep Nurhan Sara�o�lu¹, Ay�e Esra Koku Aksu²
¹Osmangazi �niversitesi T�p Fak�ltesi, Deri ve Z�hrevi Hastal�klar� Anabilim Dal�, Eski�ehir, T�rkiye
²�stanbul E�itim ve Ara�t�rma Hastanesi, Dermatoloji Klini�i, �stanbul, T�rkiye

Ama�: Bu �al��mada; plak tip psoriazis tedavisinde asitretin ve dar bant UVB ile plasebo ve dar bant UVB kombinasyonunun tedavideki etkinliklerinin kar��la�t�r�lmas�, ayr�ca psoriazis ve tedavisinin ya�am kalitesine olan etkisinin belirlenmesi ama�land�.
Gere� ve y�ntem: Bu �al��mada v�cut y�zey alan�n�n %10�undan fazlas� tutulmu� plak tip psoriazisi olan 50 hasta, ya� ve cinsiyet a��s�ndan farkl�l�k olmayan 25�er ki�ilik 2 gruba ayr�ld�. Birinci gruba dar bant UVB ile birlikte 25 mg/g�n oral asitretin tedavisi, ikinci gruba dar bant UVB ile plasebo tedavisi verildi. Hastalar 12 hafta boyunca 2 haftada bir olacak �ekilde de�erlendirildi. Her kontrolde ba��ms�z bir g�zlemci taraf�ndan PASI de�erlendirildi. Hasta taraf�ndan de�erlendirilen SAPASI hesapland�. Tedavi �ncesi ve sonras�nda hastalar�n ya�am kalitesi Skindex 29 ile de�erlendirildi.
Bulgular: �al��maya 18 ila 71 ya�lar� aras�nda 25�i (%50) erkek ve 25�i (%50) kad�n toplam 50 hasta al�nd�. Haftalara g�re PASI ve SAPASI de�i�imlerine bak�ld��nda iki grup aras�nda 2.haftada anlaml� farkl�l�k saptand� (p< 0.05). �ki grubun 4.hafta, 6.hafta, 8.hafta, 10.hafta ve 12.hafta PASI ve SAPASI de�erleri aras�nda anlaml� farkl�l�k saptand� (p<0.001). Asitretin ve dar bant UVB kombinasyonunu ile tek ba��na dar bant UVB tedavisi alanlara g�re klinik yan�t�n daha iyi oldu�u g�zlendi. Ya�am kalitesine etkisi a��s�ndan her iki tedavi protokol�n�nde de Skindex 29�un semptom, fonksiyon ve emosyon skalalar� skorlar�nda ileri d�zeyde anlaml� d�zelme sa�lad�� g�zlendi.
Sonu�: Dar bant UVB ve asitretin almaya uygun psoriazis vulgarisli hastalarda k�sa s�rede iyi yan�t al�nmas� nedeniyle kombinasyon tedavisi tercih edilebilir. Psoriazis hastan�n ya�am kalitesini �nemli d�zeyde etkileyen bir hastal�k olarak ele al�nmal� ve ya�am kalitesi �l�ekleri kullan�lmal�d�r.

Anahtar Kelimeler: Psoriasis, dar bant UVB, asitretin, Skindex 29

G�lhan G�rel, Zeynep Nurhan Sara�o�lu, Ay�e Esra Koku Aksu. A single-blind study comparing acitretin and narrow-band UVB with the combination of placebo and narrow-band UVB in the treatment of plaque-type psoriasis. Turkderm-Turk Arch Dermatol Venereol. 2015; 49(1): 2-6

Corresponding Author: G�lhan G�rel, T�rkiye

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