In summary, phototherapy provides good control of clinical symptoms in the short term for patients with moderate-to-severe plaque-type psoriasis that have failed or are unresponsive to management with topical agents. Lasers and Emerging Light Technology in the Treatment of Psoriasis. First, only the psoriasis is treated, so uninvolved skin is not subjected to the adverse effects of phototherapy. A recent study demonstrated the effectiveness of the 308 nm excimer UVB laser during a multicenter open trial. In the five tiers of quality of clinical study evidence, randomized controlled trials (RCTs) are viewed with the most regard.
Psoriasis is a common, chronic, autoimmune inflammatory skin disease affecting 2 to 3 percent of the worldwide population. In 2008, Schmitt and colleagues published a meta-analysis analyzing the efficacy and tolerability of biologic and nonbiologic systemic agents for moderate-to-severe plaque psoriasis.18 This study examined all randomized controlled trials published before January 2008 that enrolled greater than 50 patients with moderate-to-severe plaque psoriasis. Since the completion of this systematic review, the first head-to-head trial comparing a biologic to a nonbiologic systemic treatment has been published. As suggested in the public comments, we will consider when evaluating efficacy data whether patients were na ve to biologics, were treated previously with biologics, or were allowed drug holidays. Phototherapy (eg, excimer laser) and systemic agents are additional treatment options for patients who cannot achieve sufficient improvement with topical agents 10. However, these drugs appear to be particularly effective in the treatment of pustular psoriasis, and we consider them first line therapy. Placebo-controlled randomized trials evaluating the efficacy of secukinumab administered with an autoinjector or prefilled syringe on moderate to severe psoriasis also support the drug’s efficacy 158,159. The efficacy and effectiveness of each intervention was evaluated using evidence-based criteria. Trehan M, Taylor CR (2002) Medium-dose 308-nm excimer laser for the treatment of psoriasis.
Electra Nicolaidou, Christina Antoniou, Alexander Stratigos, Andreas D Katsambas (2009) Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: a review. Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser. Combination therapies are often more effective than one treatment alone. In some cases, nail psoriasis is the only symptom. Loss of Effectiveness. In most cases, people become tolerant to the effects of the drugs, and the drugs no longer work as well as they should. Treatment fluences were constant throughout the study period of 4 weeks. The use of 308-nm excimer laser to specifically treat psoriatic lesions has been reported since 1997. This is probably because his psoriatic lesions elsewhere on the body also worsened, as reflected by the increase in the PSI score of the control plaque.
Biologic And Nonbiologic Systemic Agents And Phototherapy For Treatment Of Chronic Plaque Psoriasis
Efficacy and safety of adalimumab in Chinese patients with moderate to severe plaque psoriasis: Results from a phase 3, randomized, placebo-controlled, double-blind Study. Excimer laser for treatment of generalized psoriasis. Phase I evaluation of the vasoconstrictor potential of an innovative fixed combination calcipotriene plus betamethasone dipropionate aerosol foam versus other corticosteroid psoriasis treatments. We believe that, from these studies, it will be possible to make accurate clinical predictions regarding: risk of internal malignancy, risk of lung disease, or response to various therapeutic agents. These observations will require confirmation in a larger trial powered to evaluate efficacy. United States, where the excimer laser is approved for psoriasis treatment. Marked improvement in nail psoriasis during treatment with etanercept. 01/01/2009 – The marked improvement of our two cases indicates that adalimumab may also help ameliorate nail psoriasis and warrants further controlled studies to establish the effectiveness and therapeutic regimes. Monoclonal antibody CNTO 1275 (CNTO 1275)FDA Link 09/30/2015 – To the best of our knowledge, these are the first cases reported in the literature describing the long-term good efficacy of ustekinumab not only on paradoxical forms of psoriasis induced by anti-TNF- drugs, but also on the articular involvement in a patient affected by RA and in a patient affected by Sj gren syndrome. Evaluation of a novel 308-nm monochromatic excimer light delivery system in dermatology: a pilot study in different chronic localized dermatoses.