Twice- vs. thrice-weekly MPD PUVA in psoriasis: a randomized-controlled efficacy study.

Area of Science:

• Dermatology
• Phototherapy
• Psoriasis Treatment

Background:

• Oral psoralen-ultraviolet A (PUVA) is a primary treatment for moderate to severe psoriasis.
• Existing protocols lack global standardization, with both twice- and thrice-weekly regimens utilized.
• This study aimed to compare the efficacy of these differing PUVA frequencies.

Purpose of the Study:

• To compare the efficacy of twice-weekly versus thrice-weekly oral psoralen-ultraviolet A (PUVA) regimens for psoriasis treatment.
• To evaluate differences in treatment duration and cumulative ultraviolet A (UVA) dosage between the two regimens.

Main Methods:

• A half-body study design was employed in 28 patients with psoriasis involving at least 20% body surface area.
• Each patient's body half was randomized to receive either twice- or thrice-weekly PUVA.
• The Psoriasis Area and Severity Index (PASI) score was assessed by a blinded dermatologist at baseline and upon clearance or after 25 sessions.

Main Results:

• Twenty-three patients completed the study, showing no significant difference in median PASI score decrease between twice-weekly (92.9%) and thrice-weekly (94.8%) PUVA.
• The twice-weekly regimen required significantly fewer sessions for clearance (median 15 vs. 22 sessions).
• Lower cumulative ultraviolet A (UVA) doses were observed with the twice-weekly regimen (median 142.5 J/cm² vs. 241.4 J/cm²).

Conclusions:

• Twice-weekly and thrice-weekly oral PUVA demonstrate comparable efficacy in treating moderate to severe psoriasis.
• The twice-weekly PUVA regimen is more efficient, requiring fewer treatment sessions and reduced cumulative UVA exposure.
• This suggests potential benefits in patient compliance and reduced long-term risk with a less frequent dosing schedule.