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; combined therapy may be more effective than either treatment alone in treating moderate to severe plaque psoriasis. METHODS: This study investigated the efficacy 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.