Treatment of Moderate to Severe Plaque Psoriasis With Concomitant Efalizumab and Narrow-Band Ultraviolet B Phototherapy

Background: Efalizumab therapy and narrow-band ultraviolet B (NB-UVB) phototherapy have different mechanisms of action; com- bined therapy may be more effective than either treatment alone in treating moderate to severe plaque psoriasis.
Methods: This study investigated the effi cacy and safety of efalizumab (1 mg/kg/wk) combined with NB-UVB 3 times a week for 12 weeks, followed by efalizumab monotherapy for 12 additional weeks.
Results: Twenty patients were enrolled with mean Psoriasis Area and Severity Index (PASI) of 12.8±7.4, mean physician’s global assessment (PGA) of 5±1, and mean body surface area (BSA) affected of 18.2%±15.3% at baseline. At week 12, 65% of patients (n=13) achieved PASI 75; mean PGA was 2±1, corresponding to a 60% reduction; and mean BSA was 4.7%±4.1%, corresponding to a 74% reduction. The improvements seen at week 12 were maintained during the ensuing efalizumab monotherapy.
Conclusion: Combination of efalizumab and NB-UVB followed by efalizumab monotherapy was effective and well tolerated, this warranting further investigation.