ReportAdherence to acitretin and home narrowband ultraviolet B phototherapy in patients with psoriasis
Section snippets
Methods
After obtaining institutional review board approval, 27 patients were recruited with moderate to severe plaque-type psoriasis, defined as a body surface area coverage greater than 10% and either a Psoriasis Area Severity Index score greater than or equal to 12 or an Investigator Global Assessment score greater than or equal to 3. Eligible patients were adult men and women not of childbearing potential with no contraindications to acitretin or phototherapy. A 4-week washout was required for any
Results
Of the 27 enrolled participants, 22 completed the 12-week study (Fig 1). Of the patients, 63% were men, 70% were Fitzpatrick skin types I or II, and the mean age was 50 years (Table I). Secondary to elevated triglycerides, the daily acitretin dose was reduced to 10 mg in 4 of the patients. Adherence data were collected on all 22 patients for acitretin, but data were available on only 16 patients for UVB adherence (Fig 1) secondary to difficulties with retrieval of the monitors from
Discussion
Adherence to treatment remains a major obstacle in the care of patients with psoriasis. Many factors influence a patient's adherence to a given therapy, including perceptions about safety, side effects, time consumption, and complexity of the regimen.11, 12, 13 If patients have the perception that the prescribed treatment is not safe, or if they experience side effects from the medication, they are less likely to use it.12 Likewise, if the treatment regimen is perceived as too complex or
References (14)
- et al.
Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction
J Investig Dermatol Symp Proc
(2004) - et al.
Patient compliance with paper and electronic diaries
Control Clin Trials
(2003) - et al.
Adherence to topical therapy decreases during the course of an 8-week psoriasis clinical trial: commonly used methods of measuring adherence to topical therapy overestimate actual use
J Am Acad Dermatol
(2004) - et al.
Different methods of presenting risk information and their influence on medication compliance intentions: results of three studies
Clin Ther
(2006) - et al.
Adherence to topical therapy increases around the time of office visits
J Am Acad Dermatol
(2007) - et al.
The efficacy of combination treatment with narrowband UVB (TL-01) and acitretin vs narrowband UVB alone in plaque-type psoriasis: a retrospective study
J Med Assoc Thai
(2006) - et al.
Retrospective study of the efficacy of narrowband UVB and acitretin
J Dermatolog Treat
(2003)
Cited by (0)
Supported by National Biologic Corporation and Connetics.
Disclosure: Dr Feldman has received research, speaking, and/or consulting support from Connetics, Roche, Amgen, Biogen, and Genentech. Drs Yentzer, Yelverton, Pearce, Fleischer, and Balkrishnan; Mr Camacho; Ms Makhzoumi; Ms Clark; and Ms Boles have no conflicts of interest to declare.
Reprints not available from the authors.