Clinical and genetic predictors of response to narrowband ultraviolet B for the treatment of chronic plaque psoriasis.

Hdl Handle:
http://hdl.handle.net/10147/207694
Title:
Clinical and genetic predictors of response to narrowband ultraviolet B for the treatment of chronic plaque psoriasis.
Authors:
Ryan, C; Renfro, L; Collins, P; Kirby, B; Rogers, S
Affiliation:
Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland., caitriona.ryan@baylorhealth.edu
Citation:
Br J Dermatol. 2010 Nov;163(5):1056-63. doi: 10.1111/j.1365-2133.2010.09985.x.
Journal:
The British journal of dermatology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207694
DOI:
10.1111/j.1365-2133.2010.09985.x
PubMed ID:
20716226
Abstract:
BACKGROUND: There is considerable variability in the number of exposures of narrowband ultraviolet B (NB-UVB) needed to clear psoriasis and in the duration of remission. OBJECTIVES: We assessed clinical parameters as predictors of the number of exposures needed to clear psoriasis and of the duration of remission. The influence of genetic polymorphisms of the vitamin D receptor (VDR) on treatment response was also evaluated. METHODS: This was a prospective study of 119 patients with chronic plaque psoriasis treated with NB-UVB until clearance was achieved. They were then followed for up to 1 year or until relapse occurred. The frequency of the Fok1, Apa1, Bsm1, Taq1 and rs4516035 polymorphisms of the VDR gene was assessed in 93 of the 119 patients. RESULTS: Of the 119 patients, 105 completed the course of phototherapy. Using an intention to treat analysis, 83% of the initial cohort (99 of 119 patients) achieved clearance, in a median of 26 exposures (interquartile range 19-35) with a median remission duration of 16 weeks (interquartile range 9-22). Factors significantly associated with a lower number of exposures to clearance included a lower baseline Psoriasis Area and Severity Index (P = 0.004), lower baseline Dermatology Life Quality Index (P = 0.047), female sex (P = 0.043), lower body weight (P = 0.008), and a higher number of previous courses of TL-01 (P = 0.005). The only clinical factor influencing remission duration was number of exposures (P = 0.0009), with a decreased remission duration in those who required a greater number of exposures to clear. The Taq1 VDR polymorphism (rs731236) also significantly predicted remission duration (P = 0.038). Patients homozygous for the C allele, which is associated with decreased activity of the VDR, had a shorter remission duration than those heterozygous for the allele (P = 0.026) and those homozygous for the T allele (P = 0.013). CONCLUSIONS: This study highlights the fact that both genetic and clinical parameters are important in determining treatment outcomes in psoriasis.
Language:
eng
MeSH:
Adult; Chronic Disease; Dose-Response Relationship, Radiation; Female; Humans; Male; Middle Aged; Polymorphism, Genetic; Prospective Studies; Psoriasis/diagnosis/genetics/*radiotherapy; Receptors, Calcitriol/*genetics; Severity of Illness Index; Ultraviolet Therapy/*methods
ISSN:
1365-2133 (Electronic); 0007-0963 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorRyan, Cen_GB
dc.contributor.authorRenfro, Len_GB
dc.contributor.authorCollins, Pen_GB
dc.contributor.authorKirby, Ben_GB
dc.contributor.authorRogers, Sen_GB
dc.date.accessioned2012-02-01T10:35:10Z-
dc.date.available2012-02-01T10:35:10Z-
dc.date.issued2012-02-01T10:35:10Z-
dc.identifier.citationBr J Dermatol. 2010 Nov;163(5):1056-63. doi: 10.1111/j.1365-2133.2010.09985.x.en_GB
dc.identifier.issn1365-2133 (Electronic)en_GB
dc.identifier.issn0007-0963 (Linking)en_GB
dc.identifier.pmid20716226en_GB
dc.identifier.doi10.1111/j.1365-2133.2010.09985.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207694-
dc.description.abstractBACKGROUND: There is considerable variability in the number of exposures of narrowband ultraviolet B (NB-UVB) needed to clear psoriasis and in the duration of remission. OBJECTIVES: We assessed clinical parameters as predictors of the number of exposures needed to clear psoriasis and of the duration of remission. The influence of genetic polymorphisms of the vitamin D receptor (VDR) on treatment response was also evaluated. METHODS: This was a prospective study of 119 patients with chronic plaque psoriasis treated with NB-UVB until clearance was achieved. They were then followed for up to 1 year or until relapse occurred. The frequency of the Fok1, Apa1, Bsm1, Taq1 and rs4516035 polymorphisms of the VDR gene was assessed in 93 of the 119 patients. RESULTS: Of the 119 patients, 105 completed the course of phototherapy. Using an intention to treat analysis, 83% of the initial cohort (99 of 119 patients) achieved clearance, in a median of 26 exposures (interquartile range 19-35) with a median remission duration of 16 weeks (interquartile range 9-22). Factors significantly associated with a lower number of exposures to clearance included a lower baseline Psoriasis Area and Severity Index (P = 0.004), lower baseline Dermatology Life Quality Index (P = 0.047), female sex (P = 0.043), lower body weight (P = 0.008), and a higher number of previous courses of TL-01 (P = 0.005). The only clinical factor influencing remission duration was number of exposures (P = 0.0009), with a decreased remission duration in those who required a greater number of exposures to clear. The Taq1 VDR polymorphism (rs731236) also significantly predicted remission duration (P = 0.038). Patients homozygous for the C allele, which is associated with decreased activity of the VDR, had a shorter remission duration than those heterozygous for the allele (P = 0.026) and those homozygous for the T allele (P = 0.013). CONCLUSIONS: This study highlights the fact that both genetic and clinical parameters are important in determining treatment outcomes in psoriasis.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshChronic Diseaseen_GB
dc.subject.meshDose-Response Relationship, Radiationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPolymorphism, Geneticen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshPsoriasis/diagnosis/genetics/*radiotherapyen_GB
dc.subject.meshReceptors, Calcitriol/*geneticsen_GB
dc.subject.meshSeverity of Illness Indexen_GB
dc.subject.meshUltraviolet Therapy/*methodsen_GB
dc.titleClinical and genetic predictors of response to narrowband ultraviolet B for the treatment of chronic plaque psoriasis.en_GB
dc.contributor.departmentDepartment of Dermatology, St Vincent's University Hospital, Dublin, Ireland., caitriona.ryan@baylorhealth.eduen_GB
dc.identifier.journalThe British journal of dermatologyen_GB
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.