Comparative study of the effect of narrowband ultraviolet B phototherapy plus methotrexate vs. narrowband ultraviolet B alone and methotrexate alone in the treatment of plaque-type psoriasis

BackgroundWidespread psoriasis has great effects on life. Effective and rapid response in the treatment is needed. So this study was done to compare the efficacy of combined narrowband ultraviolet-B (NBUVB) plus methotrexate (MTX) versus each one alone in the treatment of psoriasis. MethodsA total of 120 patients with widespread plaque-type psoriasis were enrolled, but only 113 patients completed the study. They were divided into three groups randomly, group MN (38) received NBUVB plus MTX, group N (38) received NBUVB alone, and group M (37) received MTX only. End point of treatment (clearance) was 90% reduction in Psoriasis Area and Severity Index (PASI) Score or up to six months, whichever was earlier; follow-up was done for one year. ResultsThe mean number of weeks required for achieving clearance was 6.111.28weeks in group MN, 11.42 +/- 2.36weeks in group N, and 20.87 +/- 4.21weeks in group M (P<0.0001). The mean number of phototherapy sessions was 17.86 +/- 3.74 sessions in group MN, and 33.51 +/- 6.9 sessions in group N (P<0.0001). The mean total cumulative dose of NBUVB for achieving clearance was 12.13 +/- 4.02J/cm(2) in group MN, compared with 34.48 +/- 13.13J/cm(2) in group N (P<0.0001), while the mean total cumulative dose of MTX was 116.04 +/- 20.47mg in group MN compared with 298.63 +/- 60.26mg in group M (P<0.0001). ConclusionsCombination of NBUVB plus MTX provided rapid improvement with less cumulative doses of both therapies compared with each one alone in the treatment of psoriasis.