RGD Reference Report - Clinical and genetic predictors of response to narrowband ultraviolet B for the treatment of chronic plaque psoriasis. - Rat Genome Database

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Clinical and genetic predictors of response to narrowband ultraviolet B for the treatment of chronic plaque psoriasis.

Authors: Ryan, C  Renfro, L  Collins, P  Kirby, B  Rogers, S 
Citation: Ryan C, etal., Br J Dermatol. 2010 Nov;163(5):1056-63. doi: 10.1111/j.1365-2133.2010.09985.x.
RGD ID: 8158081
Pubmed: PMID:20716226   (View Abstract at PubMed)
DOI: DOI:10.1111/j.1365-2133.2010.09985.x   (Journal Full-text)

BACKGROUND: There is considerable variability in the number of exposures of narrowband ultraviolet B (NB-UVB) needed to clear psoriasis and in the duration of remission. OBJECTIVES: We assessed clinical parameters as predictors of the number of exposures needed to clear psoriasis and of the duration of remission. The influence of genetic polymorphisms of the vitamin D receptor (VDR) on treatment response was also evaluated. METHODS: This was a prospective study of 119 patients with chronic plaque psoriasis treated with NB-UVB until clearance was achieved. They were then followed for up to 1 year or until relapse occurred. The frequency of the Fok1, Apa1, Bsm1, Taq1 and rs4516035 polymorphisms of the VDR gene was assessed in 93 of the 119 patients. RESULTS: Of the 119 patients, 105 completed the course of phototherapy. Using an intention to treat analysis, 83% of the initial cohort (99 of 119 patients) achieved clearance, in a median of 26 exposures (interquartile range 19-35) with a median remission duration of 16 weeks (interquartile range 9-22). Factors significantly associated with a lower number of exposures to clearance included a lower baseline Psoriasis Area and Severity Index (P = 0.004), lower baseline Dermatology Life Quality Index (P = 0.047), female sex (P = 0.043), lower body weight (P = 0.008), and a higher number of previous courses of TL-01 (P = 0.005). The only clinical factor influencing remission duration was number of exposures (P = 0.0009), with a decreased remission duration in those who required a greater number of exposures to clear. The Taq1 VDR polymorphism (rs731236) also significantly predicted remission duration (P = 0.038). Patients homozygous for the C allele, which is associated with decreased activity of the VDR, had a shorter remission duration than those heterozygous for the allele (P = 0.026) and those homozygous for the T allele (P = 0.013). CONCLUSIONS: This study highlights the fact that both genetic and clinical parameters are important in determining treatment outcomes in psoriasis.

RGD Manual Disease Annotations    Click to see Annotation Detail View
TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
psoriasis treatmentIAGP 8158081DNA:silent mutation:cds:pI352 (rs731236) (human)RGD 
psoriasis treatmentISOVDR (Homo sapiens)8158081; 8158081DNA:silent mutation:cds:pI352 (rs731236) (human)RGD 

Phenotype Annotations    Click to see Annotation Detail View

Manual Human Phenotype Annotations - RGD

TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
Psoriasiform dermatitis treatmentIAGP 8158081DNA:silent mutation:cds:pI352 (rs731236)RGD 
Objects Annotated

Genes (Rattus norvegicus)
Vdr  (vitamin D receptor)

Genes (Mus musculus)
Vdr  (vitamin D (1,25-dihydroxyvitamin D3) receptor)

Genes (Homo sapiens)
VDR  (vitamin D receptor)


Additional Information