The effect of methoxsalen dose on ultraviolet-A-induced erythema

Sally H. Ibbotson, Robert S. Dawe, Peter M. Farr

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)

    Abstract

    There is considerable interindividual variation in bioavailability of Methoxsalen (8-methoxypsoralen) after ingestion of the standard dose used in photochemotherapy (psoralen plus ultraviolet A). A dose change may be used to alter the degree of photosensitivity, although there is limited information on the effect of 8-methoxypsoralen dose alterations on phototoxicity within individuals. We studied the effect of changes of 8-methoxypsoralen dose over a narrow range in 15 subjects with psoriasis. Two hours after ingestion, serum 8-methoxypsoralen concentration was determined and phototesting was performed at 350 30 nm (0.45–14 J per cm2). The minimal phototoxic dose at 72 h was recorded, erythema was measured using a reflectance instrument, and dose–response curves were constructed. Each subject was tested on three occasions using doses of 25 mg per m2 (conventional dose) or conventional dose 10 mg. Median serum 8-methoxypsoralen concentration increased from 96 to 143 to 229 ng per ml with dose increases from conventional dose - 10 mg to conventional dose and conventional dose + 10 mg, respectively (p <&hairsp;0.001). The median minimal phototoxic dose and D0.025 (the objective equivalent of the minimal phototoxic dose derived from the dose–response curve) were significantly reduced with increasing 8-methoxypsoralen dose from conventional dose minus 10 mg (minimal phototoxic dose 1.7 J per cm2; D0.025 2.8 J per cm2) to conventional dose (1.2; 1.4 J per cm2) and conventional dose plus 10 mg (0.9; 1.0 J per cm2) (p <&hairsp;0.001). Change in 8-methoxypsoralen dose had no detectable effect on the maximum slope of the psoralen plus ultraviolet A erythema dose–response curve. Thus, 8-methoxypsoralen dose changes within individuals, over a narrow but clinically relevant range, significantly altered the threshold response to psoralen plus ultraviolet A erythema but not the rate of increase in erythema with increasing ultraviolet A dose.
    Original languageEnglish
    Pages (from-to)813-815
    Number of pages3
    JournalJournal of Investigative Dermatology
    Volume116
    Issue number5
    DOIs
    Publication statusPublished - May 2001

    Keywords

    • Osmolar Concentration
    • Ultraviolet Rays
    • Erythema
    • Methoxsalen
    • Dose-Response Relationship, Drug
    • Humans
    • Adult
    • Aged
    • PUVA Therapy
    • Middle Aged
    • Dose-Response Relationship, Radiation

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