Fumaric acid esters in combination with a 6-week course of narrow-band UVB provides for an accelerated response as compared to fumaric acid esters monotherapy.

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Fumaric acid esters in combination with a 6-week course of narrow-band UVB provides for an accelerated response as compared to fumaric acid esters monotherapy in patients with moderate to severe plaque psoriasis: A randomized prospective clinical study S. Tzaneva, A. Geroldinger, H. Trattner, A. Tanew British Journal of Dermatology. DOI: 10.111/bjd.16106

Stanislava Tzaneva, Lead author

Introduction What’s already known? Fumaric acid esters (FAE) - effective and safe systemic treatment option for psoriasis but slow onset of action Narrow-band UVB phototherapy - rapid improvement or clearing of psoriasis but not suitable for maintenance treatment

Methods Randomized, assessor-blinded trial Patients with a Psoriasis Area and Severity Index (PASI) of ≥10 and a body surface area (BSA) of ≥10 Randomization to either monotherapy with FAE (n=16) or a combination of FAE with NB UVB (n=14)

Results Thirty patients (19 males, 11 females; median age 52 years, IQR 36;56) were analysed The mean reduction in PASI after 6 weeks was significantly greater with the combination treatment as compared to FAE monotherapy (p=0.016) Much faster improvement in DLQI in the combination group than in the FAE monotherapy group

Results Time course of median PASI changes during treatment. Error bars represent interquartile ranges.

Discussion What does this study add? Combination of FAE with a short initial 6-week course of narrow-band UVB provides for an accelerated and enhanced clinical response during the early phase of treatment that is paralleled by a faster improvement of patients' quality of life.

Conclusions Adding a 6-week course of narrow-band UVB to FAE both accelerates and augments the therapeutic response during the early phase of treatment and increases quality of life in patients with moderate-to- severe plaque psoriasis.

Adrian Tanew, Senior author

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