Comparative study of the effect of narrowband ultraviolet B phototherapy plus methotrexate vs. narrowband ultraviolet B alone and methotrexate alone in the treatment of plaque-type psoriasis

Abstract

Background: Widespread psoriasis has great effects on life. Effective and rapid response in the treatment is needed. So this study was done to compare the efficacy of combined narrowband ultraviolet-B (NBUVB) plus methotrexate (MTX) versus each one alone in the treatment of psoriasis. Methods: A total of 120 patients with widespread plaque-type psoriasis were enrolled, but only 113 patients completed the study. They were divided into three groups randomly, group MN (38) received NBUVB plus MTX, group N (38) received NBUVB alone, and group M (37) received MTX only. End point of treatment (clearance) was 90% reduction in Psoriasis Area and Severity Index (PASI) Score or up to six months, whichever was earlier; follow-up was done for one year. Results: The mean number of weeks required for achieving clearance was 6.11 ± 1.28 weeks in group MN, 11.42 ± 2.36 weeks in group N, and 20.87 ± 4.21 weeks in group M (P < 0.0001). The mean number of phototherapy sessions was 17.86 ± 3.74 sessions in group MN, and 33.51 ± 6.9 sessions in group N (P < 0.0001). The mean total cumulative dose of NBUVB for achieving clearance was 12.13 ± 4.02 J/cm2 in group MN, compared with 34.48 ± 13.13 J/cm2 in group N (P < 0.0001), while the mean total cumulative dose of MTX was 116.04 ± 20.47 mg in group MN compared with 298.63 ± 60.26 mg in group M (P < 0.0001). Conclusions: Combination of NBUVB plus MTX provided rapid improvement with less cumulative doses of both therapies compared with each one alone in the treatment of psoriasis.