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Adalimumab, a fully human anti-tumor necrosis factor (TNF) monoclonal antibody has been approved for the treatment of moderate to severe psoriasis. However, in a portion of cases adalimumab does not induce reduction of psoriasis area and severity index (PASI) of 75% or greater, now being considered as gold standard for treatment efficacy. In this study we aim to determine in a randomized half-side comparison whether additional narrowband UVB-311nm phototherapy accelerates and improves the clearance of psoriatic lesions in adalimumab-treated patients after initial slow response.
Patients with moderate to severe psoriasis who have received treatment with adalimumab (loading dose of 80 mg and thereafter 40 mg s.c. biweekly) for at least 6 weeks without a PASI reduction of 75% or greater qualify for the study. Adalimumab is continued and UVB-311nm phototherapy is added at 6 weeks or thereafter one a randomized body half (left or right; head exempt) 3 x per week until complete response (defined as reduction in PASI to < 3) for a maximum of another 6 weeks (until week 12). PASI score, visual analogue score (VAS) patient score for therapeutic response, and VAS patient score for severity of skin lesions is assessed weekly; and at follow-up visits at month 3, 6, and 12. Paired Wilcoxon testing for differences in PASI and patient VAS scores is done; Fischer exact test is applied to determine differences in complete remission, PASI reduction > 90%, > 75% and/or 50% between body sites.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| left/right | Other | left or right body side |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| UVB-311nm | Radiation | UVB-311nm radiation given 3 times a week to one randomized body half |
|
| Measure | Description | Time Frame |
|---|---|---|
| Modified PASI (psoriasis area and severity index) | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| VAS patient score for therapeutic effect | 12 months | |
| VAS patient score for severity of skin lesions | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Peter Wolf, MD | Contact | +43 316 385 | 80315 | peter.wolf@medunigraz.at |
| Angelika Hofer, MD | Contact | +43 316 385 | 80315 | angelika.hofer@medunigraz.at |
| Name | Affiliation | Role |
|---|---|---|
| Peter Wolf, MD | Medical University of Graz | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of Graz, Department of Dermatology | Recruiting | Graz | A-8036 | Austria |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Oct 27, 2017 | |
| Reset | Aug 3, 2018 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Oct 27, 2017 | Aug 3, 2018 |
| ID | Term |
|---|---|
| D011565 | Psoriasis |
| ID | Term |
|---|---|
| D017444 | Skin Diseases, Papulosquamous |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| No treatment | Other | no UV exposure |
|