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Economica
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#1 Strategy to manage the treatment of severe psoriasis: considerations of efficacy, safety, and cost.
Feldman SR; Garton R; Averett W; Balkrishnan R; and Vallee J. Expert Opinion On Pharmacotherapy [Expert Opin Pharmacother] 2003 Sep; Vol. 4 (9), pp. 1525-33. |
| ABSTRACT:
Psoriasis is a common, unpredictable, chronic immune-mediated disease characterised by skin lesions and frequently associated with arthritis. Although rarely fatal, psoriasis has a tremendous impact on a patients' quality of life. Traditional therapies for severe psoriasis include phototherapy, methotrexate, oral retinoids and cyclosporin. New biological agents add to the treatment options for psoriasis; however, they raise the already considerable cost of managing the disease. In considering efficacy, safety and cost-effectiveness, ultraviolet Type B (UVB) phototherapy appears to be the best first-line agent for the control of psoriasis. Methotrexate, psoralen plus UVA, alefacept, etanercept and infliximab are appropriate second-line agents, the choice of which requires considerable patient input and physician judgement. Developing rational, effective and acceptable strategies to manage psoriasis treatments would encourage cost-effective psoriasis management. |
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#2 Narrow-band ultraviolet B treatment for vitiligo, pruritus, and inflammatory dermatoses. Samson Yashar S. Photodermatology, Photoimmunology & Photomedicine [Photodermatol Photoimmunol Photomed], 2003 Aug; Vol. 19 (4), pp. 164-8; PMID: 12925186 |
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BACKGROUND:
Narrow-band ultraviolet B (NB-UVB) therapy has been used successfully for the treatment of inflammatory and pigmentary skin disorders including atopic dermatitis, psoriasis, mycosis fungoides, polymorphous light eruption, and vitiligo. METHODS: This is a retrospective review of the treatment outcomes of 117 consecutive patients with vitiligo, pruritus, and other inflammatory dermatoses, excluding those with psoriasis and CTCL, who were treated with NB-UVB between 1998 and 2001 at our institution. RESULTS: Approximately 80% of all patients showed improvement in their condition. NB-UVB phototherapy was well tolerated, with no serious adverse effects. In patients with vitiligo, 6.4% had an abnormal thyroid-stimulating hormone level and 6.5% had anemia.
CONCLUSION:
NB-UVB may be considered as a viable therapeutic option in the treatment of vitiligo, pruritus, and other inflammatory dermatoses. Long-term adverse effects and cost-benefit analysis of NB-UVB therapy compared to other treatment modalities remain to be determined.
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