{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T02:10:02Z","timestamp":1769652602986,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Selecting the most appropriate therapy for psoriasis remains challenging due to variability in disease severity and individual patient factors. Among non\u2010biological treatments, methotrexate (MTX), apremilast (APRE), and narrowband UVB (NB\u2010UVB) phototherapy are widely utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare, under real\u2010world conditions, the clinical efficacy, quality of life, patient satisfaction, and immunomodulatory effects of APRE, MTX, and NB\u2010UVB in moderate\u2010to\u2010severe plaque psoriasis over 16\u2009weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This pilot prospective observational cohort study included 37 patients treated independently with APRE (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913), MTX (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), or NB\u2010UVB (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099). Clinical outcomes were assessed using PASI, BSA, PGA, DLQI scores, and the TSQM\u20109 questionnaire. Systemic and local inflammation were assessed by multiplex cytokine assays and RT\u2010PCR in\u00a0vivo and in\u00a0vitro.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By Week 16, significant improvements were observed in PASI, DLQI, and PGA scores across all groups, with no statistically significant differences in efficacy between treatments. A trend toward a greater response was observed for both MTX and APRE. APRE treatment demonstrated a tendency for more pronounced modulation of pro\u2010inflammatory cytokines compared to both MTX and NB\u2010UVB. NB\u2010UVB increased the anti\u2010inflammatory IL\u201010. Combination therapy with NB\u2010UVB and APRE further increased IL\u201010 levels and reduced IL\u201033 in HaCaT cells, suggesting synergistic immunomodulatory effects; however, the clinical relevance of these in\u00a0vitro findings remains unproven and requires further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>APRE, MTX, and NB\u2010UVB each improved clinical outcomes with comparable overall efficacy and good tolerability in this pilot cohort. Each therapeutic regime showed distinct immunomodulatory profiles with good tolerability. Personalized treatment strategies, including potential combinations, may optimize outcomes for patients with moderate\u2010to\u2010severe psoriasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/phpp.70066","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T05:45:50Z","timestamp":1764827150000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Apremilast, Methotrexate and\n                    <scp>NB<\/scp>\n                    \u2010\n                    <scp>UVB<\/scp>\n                    Phototherapy for Moderate to Severe Psoriasis: Efficacy, Safety, and Immunomodulation in Comparison"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1982-7031","authenticated-orcid":false,"given":"Alessia","family":"Balestrino","sequence":"first","affiliation":[{"name":"Department of Medicine Surgery and Dentistry, \u201cScuola Medica Salernitana\u201d University of Salerno  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Lembo","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgery and Dentistry, \u201cScuola Medica Salernitana\u201d University of Salerno  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaella","family":"Manzo","sequence":"additional","affiliation":[{"name":"Dermatology Unit, A. Tortora Hospital, Pagani  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"Battipaglia","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgery and Dentistry, \u201cScuola Medica Salernitana\u201d University of Salerno  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annunziata","family":"Nigro","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgery and Dentistry, \u201cScuola Medica Salernitana\u201d University of Salerno  Salerno Italy"},{"name":"University of Salerno, Postgraduate School in Clinical Pathology and Clinical Biochemistry  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annunziata","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgery and Dentistry, \u201cScuola Medica Salernitana\u201d University of Salerno  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214065"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16915"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2310\/7750.2012.11124"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15305"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2012.01.001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-2-12"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12612745"},{"key":"e_1_2_11_9_1","volume-title":"Otezla EPAR Public Assessment Report","author":"European Medicines Agency","year":"2019"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphotobiol.2007.04.012"},{"key":"e_1_2_11_11_1","first-page":"943","article-title":"UV\u2010Induced NF\u2010kappaB Activation and Expression of IL\u20106 Is Attenuated by (\u2212)\u2010Epigallocatechin\u20103\u2010Gallate in Cultured Human Keratinocytes In\u00a0Vitro","volume":"16","author":"Xia J.","year":"2005","journal-title":"International Journal of Molecular Medicine"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2022.2095329"},{"key":"e_1_2_11_13_1","article-title":"Apremilast or Methotrexate: The Arrows in the Quiver for Psoriasis","volume":"15","author":"Panda G.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.02.1164"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16431"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI200318986"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2024.02.002"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s12276-020-0388-y"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2011.08.003"}],"container-title":["Photodermatology, Photoimmunology &amp; Photomedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phpp.70066","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/phpp.70066","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phpp.70066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:03:01Z","timestamp":1769605381000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/phpp.70066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/phpp.70066"],"URL":"https:\/\/doi.org\/10.1111\/phpp.70066","archive":["Portico"],"relation":{},"ISSN":["0905-4383","1600-0781"],"issn-type":[{"value":"0905-4383","type":"print"},{"value":"1600-0781","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]},"assertion":[{"value":"2025-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70066"}}