Search

Background In a recent open pilot trial, R-salbutamol sulphate, a well-known molecule with anti-inflammatory effects, was tested successfully on patients with therapy-resistant discoid lupus erythematosus (DLE). Objectives To compare the efficacy and safety of R-salbutamol cream 0·5% vs. placebo on DLE lesions in a multicentre, double-blinded, randomized, placebo-controlled phase II trial. Methods Thirty-seven patients with at least one newly developed DLE lesion were randomized – 19 to the R-salbutamol cream 0·5% and 18 to placebo – and treated twice daily for 8 weeks. Efficacy was evaluated through scores of erythema, scaling/hypertrophy and induration as well as pain and itching; general improvement scored by the investigator and global improvement scored by patients’ assessment were also evaluated. Results The mean area under the curve of improvement for scaling/hypertrophy, pain, itching and global patient assessment was significantly better for the actively treated patients as compared with placebo (scaling/hypertrophy, P = 0·0262; pain, P = 0·0238; itching, P = 0·0135; global patient assessment, P = 0·045). Moreover, the percentage of patients without induration was significantly higher in the active group compared with the placebo group ( P = 0·013), and a statistically significantly greater decrease in the size of the lesional area was also seen in the overall analysis of the R-salbutamol-treated patients ( P = 0·0197). No serious adverse events were reported. Conclusions Application of R-salbutamol cream 0·5% was safe and well tolerated. Statistically significant effects were seen on scaling/hypertrophy, induration, pain and itching as well as patient global assessment, suggesting that R-salbutamol could be a promising new topical therapy alternative for DLE. [ABSTRACT FROM AUTHOR]

Background Ultraviolet (UV) A sunbeds are widely used by patients with psoriasis in an attempt to treat their skin disease. However, there is little evidence that UVA therapy improves psoriasis, and the long-term risks of sunbed exposure are not known. Objectives To perform a randomized, placebo-controlled study of UVA sunbed therapy for psoriasis. Methods A sunbed and canopy unit was modified to allow UVA exposure on one side of the body (front and back), and ‘placebo’ visible light exposure on the other side of the body. We treated 38 patients with psoriasis, giving 12 exposures over a period of 4 weeks. Assessment was made using a modified Psoriasis Area and Severity Index (PASI) score, individual plaque assessment and patient questionnaire. Results In 17 patients (47%) the PASI score showed a greater reduction on the UVA side compared with placebo, in 11 patients (31%) no difference was recorded between the two sides, and in eight (22%) the improvement was greater on the placebo-treated side. Overall, the median pretreatment half-body modified PASI score was 4·4 units, reducing to 3·9 units on the UVA-treated side and 4·2 units on the placebo-treated side (P = 0·044 for difference in response). Breakdown of the plaque score into the individual components of erythema, scale and thickness revealed significant improvement only with the score for erythema. Although the degree of improvement was small, 64% of patients felt that the response was sufficiently good that they would use a sunbed again to treat their psoriasis. Conclusions Our results show that a short course of sunbed treatment does improve psoriasis in some patients, but that the degree of improvement is small. [ABSTRACT FROM AUTHOR]