TREATMENT OF PSORIATIC-ARTHRITIS WITH EXTRACORPOREAL PHOTO CHEMOTHERAPY AND CONVENTIONAL PSORALEN-ULTRAVIOLET-A IRRADIATION

Objective. To study the use of combined photopheresis and psoralen-ult raviolet A irradiation (PUVA) in the treatment of psoriatic arthritis. Methods. Eight patients with psoriasis and seronegative arthritis rec eived photopheresis for 12 weeks, followed by photopheresis plus PUVA for another 12 weeks. Clinical and Laboratory examinations were perfor med every 3 months for up to 1 year after therapy. Results. Four patie nts experienced a marked improvement of joint symptoms that lasted for greater than or equal to 12 months post-therapy (74% decrease in the Ritchie articular index; P < 0.01). Prior to therapy, these patients h ad a higher CD4:CD8 ratio than the poor responders. Only minor laborat ory changes occurred. Conclusion. A more extensive trial of photophere sis plus PUVA in psoriatic arthritis is warranted.