P79 Long-term psoriasis management: the role of NB-UVB phototherapy and topical Cal/BD foam

Abstract Many psoriasis patients struggle to achieve long-term disease control despite numerous treatment options. Recent research suggests that some biological treatments may lead to sustained, drug-free disease control by targeting underlying immunological factors, though the exact mechanisms remain unclear. This emphasizes the need to identify treatments that contribute to longer-lasting remission. As topical treatments are essential in psoriasis management, it is crucial to determine their role alongside more advanced therapies and how they can be combined for long-term remission. This study aimed to evaluate the efficacy of full-body narrowband UVB (NB-UVB) phototherapy combined with placebo and calcipotriene/betamethasone dipropionate (Cal/BD) foam in 12 patients with plaque psoriasis. Using an open-phase, non-randomized, single-group split-body design (ClinicalTrials.gov: #NCT05185258; Danish Regional Research Ethics Committee: #78623), each patient had two plaques designated for once-daily application of Cal/BD and placebo foam at baseline. After 4 weeks, applications were reduced to twice weekly until end of treatment (EOT). During the first 8 weeks, patients received NB-UVB sessions three times weekly. Study visits were conducted at baseline (week 0), week 8, week 13, and EOT (week 18) and included clinical evaluations using the Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI), and Target Plaque Severity Score (TPSS). At weeks 8 and 13, IGA and DLQI were significantly reduced compared with baseline, indicating improved disease control and quality of life. However, scores returned to baseline levels at EOT, highlighting the short-term efficacy of NB-UVB. PASI and TPSS were significantly reduced at all visits compared with baseline. Notably, PASI and TPSS for placebo-treated plaques increased from week 8 to EOT, whereas TPSS for Cal/BD treated plaques demonstrated a sustained reduction. Moreover, Cal/BD-treated plaques exhibited significantly lower TPSS than placebo at EOT (p = 0.0429), demonstrating Cal/BD’s longer-lasting effect. To compare TPSS with overall psoriasis severity, unweighted average PASI values across body regions were used, providing a standardized total severity score predominantly reflecting non-topical-treated areas. Cal/BD and placebo-treated plaques showed significantly lower severity than the total severity at weeks 8 and 13. Interestingly, at EOT, only Cal/BD maintained significantly lower severity. In conclusion, combining Cal/BD with NB-UVB effectively reduced disease activity, improved patient outcomes, and enhanced quality of life. Cal/BD demonstrated superior efficacy compared with placebo, underscoring its potential for long-term management. Although NB-UVB can be burdensome due to frequent clinic visits and short-term efficacy, combining it with Cal/BD helps maintain therapeutic effects with a more patient-convenient regimen.