Conflict of Interest Dr. Koo has received research support and/or lecture honoraria from the following companies: Abbott Labs, Amgen, Astellas, Galderma, Genentech, Photomedex, Ranbaxy, Stiefel and Warner Chilcott. Dr. Wu has received research funding from Abbott Laboratories, Amgen and Pfizer. Dr. Park does not have any conflicts of interest to disclose.
A randomized, ‘head-to-head’ pilot study comparing the effects of etanercept monotherapy vs. etanercept and narrowband ultraviolet B (NB-UVB) phototherapy in obese psoriasis patients
Article first published online: 15 JUN 2012
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 7, pages 899–906, July 2013
How to Cite
Park, K.K., Wu, J.J. and Koo, J. (2013), A randomized, ‘head-to-head’ pilot study comparing the effects of etanercept monotherapy vs. etanercept and narrowband ultraviolet B (NB-UVB) phototherapy in obese psoriasis patients. Journal of the European Academy of Dermatology and Venereology, 27: 899–906. doi: 10.1111/j.1468-3083.2012.04611.x
Funding sources This study was supported in part by Amgen.
Role of sponsors The sponsors had no role in the design and conduct of the study; in the collection, analysis and interpretation of data; or in the preparation, review, or approval of the manuscript.
- Issue published online: 13 JUN 2013
- Article first published online: 15 JUN 2012
- Received: 1 March 2012; Accepted: 16 May 2012
Background Etanercept is a tumour necrosis factor-alpha antagonist used for the treatment of moderate-to-severe psoriasis. Current opinion suggests that etanercept may have reduced efficacy in obese patients. Narrowband ultraviolet B (NB-UVB) phototherapy is unaffected by body weight and the addition of NB-UVB to etanercept therapy may supplement the efficacy of etanercept in these patients.
Objective To evaluate the efficacy and safety of NB-UVB phototherapy when administered in conjunction with 50 mg of etanercept once weekly in the treatment of obese patients with moderate-to-severe plaque psoriasis.
Methods Thirty psoriasis patients with a body mass index (BMI) greater than 30 were enrolled into this randomized, ‘head-to-head’ comparison study. All subjects received 50 mg of etanercept twice weekly for 12 weeks and then randomized to receive either etanercept monotherapy or combination etanercept and NB-UVB three times weekly for an additional 12 weeks. Treatment response was evaluated using Psoriasis Area and Severity Index (PASI), body surface area (BSA) and Physician’s Global Assessment (PGA) scores.
Results Twenty-five subjects completed the study. At 12 weeks, 48% of all patients achieved PASI 75. By Week 24, 62.5% of all patients achieved PASI 75. Patients in the etanercept monotherapy and combination etanercept and NB-UVB phototherapy arms had similar rates of achieving PASI 75 (46.7% vs. 53.3% of each group, respectively).
Conclusion Combination etanercept and NB-UVB has similar efficacy to etanercept monotherapy in obese patients. This result indicates that even in the setting of obesity, the majority of patients respond well to etanercept, with or without NB-UVB.