Abstract
Since 1974, phototherapy with psoralen and ultraviolet A (UVA) has been used successfully for the treatment of psoriasis. However, undesirable side effects, including phototoxicity, nausea, stomach pain and headaches, have led investigators to develop new psoralen compounds. 5-Methoxypsoralen (5-MOP) has thus been introduced as an alternative to 8-MOP because of its less pronounced side effects. Since the absorption kinetics and bioactivity of 5-MOP are known to be variable, a new micronized tablet form (5-MOPm) has been developed. In an open randomized study, oral treatments with 5-MOP or 5-MOPm plus UVA radiation were compared in 22 psoriatic patients. Skin type and initial psoriasis area severity index did not differ significantly between treatment groups. Serum concentrations were significantly higher (320 vs 85.82 ng/ml) and occurred earlier (51.8 vs 229.09 min) with 5-MOPm. In addition, a reduction in PASI of more than 90% was achieved sooner (10.63 vs 17.27 treatments) and with a lower cumulative UVA dose (145.89 vs 232.11 J/cm2), in the group treated with 5-MOPm. No side effects were observed with 5-MOPm. Our data indicate that 5-MOPm has a higher bioavailibility, clinical efficacy and tolerability than the commonly used 5-MOP.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Andrew E, Nilsen A, Thune P, Wilk (1981) Photochemotherapy in psoriasis. Clinical response and 8-MOP plasma concentrations at two levels. Clin Exp Dermatol 6: 591–600
Aubin F, Manteaux A (1990) Mécanismes de photoréaction des psoralènes. Ann Dermatol Venereol 117: 931–936
Brodie RR, Irons SR, Chasseaud LF, Taylor T, Morris GR, Baker JM, Forlot P (1989) Bioavailability of 5-methoxypsoralen (5-MOP) from formulations containing the micronized and unmicronized drug. In: Fitzpatrick TB, Forlot P, Pathak MA, Urbach F (eds) Psoralens: past, present, and future of photochemoprotection and other biological activities. John Libbey Eurotext, Paris, pp 263–267
Calzavara-Pinton P, Ortel B, Carlino A, De Panfilis G (1992) A Reappraisal of the use of 5-methoxypsoralen in the therapy of psoriasis. Exp Dermatol 1: 46–51
George SA, Ferguson J (1992) Liquid formulations of 8-methoxypsoralen (8-MOP) and 5-MOP: a prospective double-blind crossover assessment of acute non-phototoxic adverse effects. Photodermatol Photoimmunol Photomed 9: 33–35
Hönigsmann H, Jaschke E, Gschnait F, Brenner W, Fritsch P, Wolff K (1979) 5-Methoxypsoralen (Bergapten) in photochemotherapy of psoriasis. Br J Dermatol 101: 369–378
Kornhauser A, Wamer WG, Giles AL (1982) Psoralen phototoxicity: correlation with serum and epidermal 8-methoxypsoralen and 5-methoxypsoralen in the guinea pig. Science 217: 733–735
Makki S, Quencez E, Humbert P, Taillard C, Agache P, Guinchard C (1985) 5-Methoxypsoralen pharmacokinetics in psoriatic patients. In: Fitzpatrick TB, Forlot P, Pathak MA, Urbach F (eds) Psoralens: past, present, and future of photochemoprotection and other biological activities. John Libbey Eurotext, Paris, pp 167–174
Makki S, Muret P, Renaud A, Agache P, Magnin P (1991) A Simple equilibrium dialysis-HPLC method for the in vitro assessment of 5-methoxypsoralen bound to human albumin. J Chromatogr 536: 443–448
Meffert H, Rowe E, Miehe M, Sonnichsen N (1986) Differenzierung von antipsoriatischer und phototoxischer EffektivitÄt bei topischer PUVA-Therapie. Hautarzt 37: 90–93
Muret P, Humbert Ph, Makki S, Bechtel P, Urien S, Tillement JP (1993) Serum 5-methoxypsoralen free fraction in health and psoriasis: relation with human serum albumin. Arch Dermatol Res 285: 287–290
Stolk LML (1980) Determination of 8-methoxypsoralen in biological fluids by reverse HPLC. Pharm Weekbl [Sci] 2: 29–32
Stolk LML, Westerhof W, Cormane RH, Van Zwieten PA (1981) Serum and urine concentrations of 5-methoxypsoralen after oral administration. Br J Dermatol 105: 415–420
Stolk LML, Siddiqui AH, Westerhof W, Cormane RH (1985) Comparison of bioavailability of two oral preparations of 5-methoxypsoralen. Br J Dermatol 112: 469–473
Swanbeck G, Ehrisson H, Ehrneb M, Wallin I, Johnson L (1979) Serum concentration and phototoxic effect of methoxypsoralen in patients with psoriasis. Clin Pharmacol Ther 25: 478–480
Tanew A, Ortel B, Rappersberger K, Hönigsmann H (1988) 5-Methoxypsoralen (Bergapten) for photochemotherapy. Bioavailability, phototoxicity, and clinical efficacy in psoriasis of a new drug preparation. J Am Acad Dermatol 18: 333–338
Treffel P, Makki S, Humbert P, Khaldoun H, Agache P (1992) A new micronized 5-methoxypsoralen preparation. Higher bioavailability and lower UVA dose requirement. Acta Derm Venereol (Stockh) 72: 65–67
Wollf K, Gschnait F, Hönigsmann H, Konrad K, Parrish JA, Fitzpatrick TB (1977) Phototesting and dosimetry for photochemotherapy. Br J Dermatol 96: 1–10
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Aubin, F., Makki, S., Humbert, P. et al. Treatment of psoriasis with a new micronized 5-methoxypsoralen tablet and UVA radiation. Arch Dermatol Res 286, 30–34 (1994). https://doi.org/10.1007/BF00375840
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00375840