Kombinationsbehandlung der Psoriasis vulgaris mit dem Vitamin D3-Derivat Tacalcitol und UVB 311 nm: Ergebnisse einer kontrollierten Halbseitenstudie / Treatment of psoriasis with a combination of tacalcitol and UVB 311 nm: An open half-side trial

Psoriasis is a chronic immune mediated disease which often leads to recurrence and frequently starts in the first half of life. As therapy anthralin, fumarates, retinoids, ultraviolet radiation (UVA/UVB) and for severe cases methotrexate, cyclosporin A und psoralen and UVA (PUVA) are well established. For the future, progress is needed to improve the handling and efficacy of the regimens and to reduce side-effects and costs. The development of UVB 311 nm radiation, the topical use of vitamin D3, and moreover, the combination of both lead to an efficient and safe ambulatory treatment modality. The combination of daily use of the vitamin D3 derivative tacalcitol (1,24(OH)2D3) and UVB 311 nm were compared to monotherapy with tacalcitol ointment in an open half-side comparison trial. After 21 days both sides were evaluated and the more efficient approach was offerred to the patient for further treatment. The combination of tacalcitol and UVB 311 nm cleared psoriasis lesions faster (p <0.001) compared to tacalcitol alone. Thus all 22 patients continued the treatment with this combination therapy. After another 21 days no difference of the PASI between the side treated before by tacalcitol alone and the side previously treated by tacalcitol/UVB 311 nm could be found (tacalcitol +UVB 311 nm: 2.01±2.917; tacalcitol alone: 2.63±2.988). In conclusion, therapy of psoriasis by daily use of tacalcitol in combination with UVB 311 nm phototherapy is a safe and efficient method for the ambulatory treatment of psoriasis which is proven to be superior to the monotherapies by tacalcitol or UVB 311 nm. UVB radiation can follow the initiation of therapy by daily tacalcitol ointment for up to three weeks to give successful results.