Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
John Cavenagh, PhD, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of a topical agent to narrowband UVB treatment is more effective in treating adults with psoriasis than narrowband UVB treatment alone.
STUDY DESIGN: Review of three English language primary randomized trials that were published between 2003 and 2012.
DATA SOURCES: A randomized left-right comparison, placebo controlled clinical trial, a randomized trial, and a randomized placebo controlled, blinded clinical trial each comparing the addition of a topical agent to narrowband UVB treatment to narrowband UVB treatment alone were found using PubMed and Cochrane databases.
OUTCOMES MEASURED: The outcomes were measured by a single investigator in each trial by analyzing the improvement of the lesions based on the induration size, redness, and scaliness using Psoriasis Area and Severity Index (PASI) and Psoriasis Severity Index (PSI) scores.
RESULTS: The results of these trials indicate that the addition of a topical agent to narrowband UVB can be effective in treating psoriasis. The Ehsani et al study concluded that while the use of 8MOP resulted in a greater score decrease, the decrease between groups was not significant. The Woo et al study concluded that while the difference in PASI scores between the groups was not significant, the active group using calcipotriol for psoriasis received less UVB. The Ozkan et al study concluded that the group treated with calcipotriol had statistically significant improvement compared to UVB monotherapy.
CONCLUSIONS: The results indicate that the addition of a topical agent to UVB therapy for adults with psoriasis is just as effective as NBUVB alone. While the use of 8MOP didn’t produce statistically significant results, the trials that used calcipotriol had favorable outcomes. The Woo et al study concluded that calcipotriol may produce UVB enhancing effects resulting in less cumulative UVB exposure. The Ozkan study concluded that the addition of calcipotriol to UVB phototherapy is more effective and efficient in treating the lesions. Further study is warranted to evaluate the use of calcipotriol and NBUVB phototherapy for the treatment of psoriasis.
Wagner, Colleen M., "Is the Addition of a Topical Agent to Narrowband UVB Treatment More Effective in Treating Male and Female Adults With Psoriasis Than Narrowband Treatment Alone?" (2014). PCOM Physician Assistant Studies Student Scholarship. 199.