Alefacept and Ultraviolet B
Combination Therapy for Psoriasis

Title: An open-label study of alefacept plus ultraviolet B light as combination therapy for chronic plaque psoriasis.
: Ortonne JP et al.
Publication: J Eur Acad Dermatol Venereol. 2005 Sep;19(5):556-63.

In clinical trials of psoriasis with the drug alefacept (a human LFA-3/IgG fusion protein), it was discovered that clinical improvement and prolonged remission of psoriasis were correlated with decreased level of circulating memory T cells. Reduction in T cells in psoriatic lesion has also been observed following ultraviolet B (UVB) light therapy.

Because alefacept and UVB target T cells in different ways, the authors wanted to see whether combining the two would lead to greater efficacy in treating chronic psoriasis. To do this, they conducted an open-label, parallel-group studies in France using narrowband UVB and the United States using broadband UVB.

Sixty patients (30 in France and 30 in the US) were given 12 weekly injections of 15 mg. alefacept and were divided into 3 groups:

  • No UVB
  • 6-week UVB treatment
  • 12-week UVB treatment

The 12-week treatment period was followed by a 12-week follow up period, with visits every 2 to 4 weeks during the follow up.

The authors reported that alefacept was well tolerated when either given by itself or in combination with UVB therapy. There was no evidence of increased sensitivity to light or side effects when given in combination.

The authors found that in either location (with narrowband or broadband UVB), the combination alefacept/UVB treatment provided overall higher response rate and more rapid response compared to alefacept by itself. In patients with 50% or greater reduction in PASI index, those who received alefacept/UVB combination treatment maintained this result throughout the follow-up phase without any further psoriasis treatment.

In conclusion, the author noted that the combination of alefacept and UVB treatment for chronic plaque psoriasis was well tolerated and had better and more rapid response than alefacept alone.

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