Relapse Rate and Duration of Therapeutic Effect of Oral Psoralen plus Ultraviolet a (PUVA) in the Treatment of Plaque-type Psoriasis: Original Data Utilizing Standardized Measures of Effect Duration
Bibliographic record
Abstract
Background Treatments with long duration of therapeutic effects are ideal for the long-term treatment of psoriasis. This study evaluates psoralen plus ultraviolet light A (PUVA) therapy using standardized definitions of relapse and durability of therapeutic effect. Objectives The purpose of this study was to evaluate the relapse rate and duration of therapeutic effect for PUVA patients who achieved at least 75% reduction in the Psoriasis Area and Severity Index (PASI 75) score after 12 weeks of treatment. Methods This study involved 40 patients with psoriasis; 30 received PUVA and 10 received UVA with placebo for 12 weeks during the double-blind treatment phase. During the post-treatment follow-up, patients who achieved PASI 75 after 12 weeks of PUVA were followed for 48 weeks without treatment to evaluate for relapse (time when subjects return to ≤50% reduction in baseline PASI) and durability of therapeutic effect (time from stopping treatment until 50% of improvement in PASI from the treatment is lost). Results Using per-protocol analysis, 18 out of the 21 patients (86%) who completed the double-blind treatment phase achieved PASI 75 after 12 weeks of PUVA. None of the placebo-treated patients achieved PASI 75. Of the patients who reached PASI 75 after 12 weeks, 89% (16/18) did not relapse after 12 weeks, 69% (11/16) did not relapse after 24 weeks, and 36% (5/14) did not relapse after 48 weeks follow-up. Of the patients who relapsed during the 48-week follow-up, the median time to relapse was 32 weeks. The durability of therapeutic effect was at least 12 weeks, 24 weeks, and 48 weeks respectively in 100% (18/18), 75% (12/16) and 42% (6/14) of the patients. Limitations The study was relatively small with only 14 patients completing the total follow-up period and per-protocol analysis was used. In addition, the patients were generally younger and less severe than those evaluated in biologic studies. There was no direct head-to-head comparison with other treatment modalities to evaluate relative relapse rates. Conclusions The study results support previous reports in the literature and the general clinical impression that PUVA provides prolonged duration of response in patients with plaque-type psoriasis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".