Narrowband ultraviolet B (NB-UVB) phototherapy may provide a promising solution for patients with chronic plaque psoriasis suffering from secondary loss of response to adalimumab, according to findings from a recent pilot study. This prospective exploratory cohort research sheds light on the potential of combining established treatments to enhance therapeutic outcomes in this challenging condition.
Biologic therapies have revolutionized the management of psoriasis; however, the problem of diminishing efficacy over time continues to pose significant challenges for both patients and clinicians. While switching between different biologic treatments is common practice, researchers suggest that integrating adjunctive therapies could be a more cost-effective strategy to reinstate therapeutic responses. NB-UVB phototherapy, known for its local immunomodulatory effects, has seen limited prior research focused on its use alongside biologics, particularly tumour necrosis factor (TNF) inhibitors like adalimumab.
This small study tracked the progress of 11 adults diagnosed with chronic plaque psoriasis who had experienced a secondary loss of response to adalimumab without the presence of anti-adalimumab antibodies. All participants maintained their standard adalimumab dose (40 mg every two weeks) while receiving NB-UVB therapy three times a week over the course of 25 to 30 sessions.
Disease severity was measured using the Psoriasis Area and Severity Index (PASI). Baseline PASI scores averaged 4.1 but elevated to 11.8 at the time of relapse, indicating a clinically significant deterioration. Remarkably, following NB-UVB treatment, the average PASI score dropped to 6.2, signifying a statistically significant improvement. When excluding non-responders, the mean PASI fell further to 4.0, aligning closely with pre-relapse levels.
Outcomes from the therapy were encouraging; 45.5% of patients (five individuals) achieved a PASI 50 response and 18.2% (two patients) reached a PASI 75 response. Notably, these clinical improvements sustained for at least 24 months, indicating a durable benefit from this combined treatment approach.
Alongside physical health improvements, patient-reported outcomes reflected a significant enhancement in quality of life. The average Dermatology Life Quality Index (DLQI) score decreased from 14.7, indicative of severe impairment, to a much more manageable 5.6 after NB-UVB therapy. The treatment was well tolerated overall, with no major adverse events reported. Despite this, three patients who did not benefit from the combination strategy opted to switch to ustekinumab.
The authors of the study conclude that adjunctive NB-UVB phototherapy offers a safe, accessible, and economically viable option for enhancing the efficacy of adalimumab in patients facing secondary treatment failure. However, they stress the importance of larger, controlled trials to validate these findings, elucidate the underlying mechanisms, and better define the role of combination therapies in managing psoriasis.
For more details, refer to the study by Tribolet de Abreu et al. in “Photochemical & Photobiological Sciences,” which highlights the potential of NB-UVB therapy as a complementary approach in chronic plaque psoriasis treatment.
Tags: psoriasis, NB-UVB phototherapy, adalimumab, chronic plaque psoriasis, combination therapy
Original Source: https://www.emjreviews.com/dermatology/news/narrowband-uvb-phototherapy-may-restore-adalimumab-response-in-chronic-plaque-psoriasis/
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Publish Date: 2026-01-03 21:35:00
