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Treatments for mild-to-moderate recalcitrant plaque psoriasis: expected clinical and economic outcomes for first-line and second-line care.

The cost effectiveness of treatments for psoriasis has been evaluated previously by several different investigators. Such evaluations should be updated as new products or data become available. To this end, a comparison of expected treatment-related clinical and economic outcomes is undertaken from the payer perspective using a disease-intervention model, decision analyses, and newly emergent information. The model is based on academy guidelines and recommended clinical practice. Model inputs (clinical and cost data) are culled from the medical literature and advisory clinical assessment surveys. Comparable therapies are various topical pharmacotherapies and phototherapies, including the 308-nm excimer laser (XTRAC, PhotoMedex, Montgomeryville, PA). Analytic results indicate that clinical and economic outcomes are influenced by treatment selections but are muted by the rotational nature of treatment regimens. Multiple analyses are required to reveal individual product performance. On the basis of these analyses, the addition of the 308-nm excimer laser to the rotational mix of treatments commonly utilized as second-line therapies for mild-to-moderate plaque psoriasis is expected to add incremental clinical benefit for patients without incremental cost for payers, because the laser can replace both more costly and less costly alternatives for appropriately selected patients who require a different therapeutic modality to maintain or improve their responsiveness.

Administration, Topical↗

[Immune shifts in patients with thyrotoxicosis under the effect of the autotransfusion of UV-irradiated blood].

The authors have carried on an investigation of humoral immunity in 64 patients with thyrotoxicosis of different degrees. It was found that patients with different degrees of thyrotoxicosis had an elevated level of immunoglobulins and that autotransfusion of UV irradiated blood considerably normalized the content of immunoglobulins in blood serum, especially in patients with mild and mean degrees of thyrotoxicosis.

Adolescent↗

[Evaluation of the effect of local corticosteroids in the phototherapy of psoriasis].

An open clinical trial was carried out in order to establish to what extent the application of topical corticosteroids with the UVB therapy influences the complete dosage of the UVB radiation required for the clearing of psoriasis and the duration of remission. Out of 30 patients who were administered the suberythemogenic UVB dosage, 15 received a topical corticosteroid and 15 an indifferent ointment (u. emolliens). Although the therapeutic response was initially somewhat more immediate in the corticosteroid--UVB group, there is no statistically significant difference between these two groups in the total UVB dosage required for the remission of the disease. The patients in the topical corticosteroid--UVB group remained in remission longer than the patients in the control group receiving no local corticosteroid.

Administration, Topical↗

The benefits, costs and risks of topical tar preparations in the treatment of psoriasis: considerations of cost effectiveness.

Cost-effectiveness analysis provides an analytical framework for comparing the costs, benefits, and risks of treatment. Using these techniques we evaluated topical tar in the treatment of psoriasis. Topical tar has, at most, a small benefit in accelerating the clearing of psoriasis. There is no systematic evidence to suggest that using topical tar during clearing extends the length of a remission. This analysis suggests that using topical tar may increase costs of therapy three-to thirteen-fold without substantial clinical benefits. Adequate data to support tar as a cost-effective agent in the treatment of psoriasis is lacking.

Administration, Topical↗

[Autotransfusion of UV-irradiated blood in the treatment of suppurative peritonitis in children].

The inclusion of autotransfusions of the UV-irradiated blood in the complex of therapeutic measures for the treatment of children with peritonitis resulted in substantial shortening of the time of treatment and in a less volume of the infusion therapy. The autotransfusion of the UV-irradiated blood brings about positive dynamics of the ABC of blood, the content of immunoglobulins in plasma becomes normal within 5-6 days. The non-specific resistance factors were found to be activated.

Acid-Base Equilibrium↗