{"id":335790,"date":"2019-08-25T02:00:00","date_gmt":"2019-08-25T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/le-traitement-puva-a-des-effets-durables\/"},"modified":"2019-08-25T02:00:00","modified_gmt":"2019-08-25T00:00:00","slug":"le-traitement-puva-a-des-effets-durables","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/fr\/le-traitement-puva-a-des-effets-durables\/","title":{"rendered":"Le traitement PUVA a des effets durables"},"content":{"rendered":"<p><strong>Des dermatologues ont montr\u00e9 dans une \u00e9tude multicentrique en Autriche qu&#8217;un traitement \u00e0 faible dose \u00e0 base de psoral\u00e8ne et de rayons UV-A (PUVA) n&#8217;entra\u00eene pas seulement une r\u00e9mission \u00e0 court terme du lymphome cutan\u00e9 &#8220;mycosis fungoides&#8221;, mais que celle-ci se maintient \u00e9galement pendant plus d&#8217;un an.  <\/strong><\/p>\n<p> <!--more--> <\/p>\n<p>Les patients atteints de mycosis fongo\u00efde ont \u00e9t\u00e9 trait\u00e9s deux fois par semaine pendant 12 \u00e0 24 semaines avec du 8-m\u00e9thoxypsoral\u00e8ne par voie orale suivi d&#8217;une irradiation aux UVA. Un traitement d&#8217;entretien n&#8217;a \u00e9t\u00e9 administr\u00e9 qu&#8217;en cas de r\u00e9ponse compl\u00e8te pendant la phase d&#8217;induction (r\u00e9duction \u00e0 z\u00e9ro avec l&#8217;outil d&#8217;\u00e9valuation modifi\u00e9 pond\u00e9r\u00e9 en fonction de la s\u00e9v\u00e9rit\u00e9, mSWAT). Ces patients ont \u00e9t\u00e9 randomis\u00e9s dans les conditions suivantes : &#8220;pas de traitement suppl\u00e9mentaire par PUVA&#8221; ou &#8220;poursuite de la PUVA en traitement d&#8217;entretien pendant neuf mois&#8221;. Comme l&#8217;a montr\u00e9 l&#8217;analyse des donn\u00e9es, 70% des patients ont obtenu une r\u00e9ponse compl\u00e8te pendant la phase d&#8217;induction avec une dose d&#8217;UVA relativement faible de 78,5&nbsp;<sup>J\/cm2<\/sup>. Les valeurs initiales du mSWAT n&#8217;\u00e9taient pas tr\u00e8s diff\u00e9rentes de celles des patients n&#8217;ayant eu qu&#8217;une r\u00e9ponse partielle. Dans le cadre du traitement d&#8217;entretien de neuf mois qui a suivi, la dur\u00e9e de la r\u00e9mission sans maladie a \u00e9t\u00e9 prolong\u00e9e de 4 \u00e0 15 mois en moyenne (p=0,02). Une analyse des effets histologiques de la PUVAth\u00e9rapie a montr\u00e9 que l&#8217;am\u00e9lioration clinique s&#8217;accompagnait d&#8217;une diminution de la densit\u00e9 des infiltrats inflammatoires et d&#8217;une r\u00e9duction de la quantit\u00e9 de s\u00e9quences clonales de r\u00e9cepteurs de cellules T. La PUVAth\u00e9rapie a \u00e9galement permis d&#8217;am\u00e9liorer la qualit\u00e9 de vie des patients. En ce qui concerne la tol\u00e9rance, aucun effet secondaire grave de la PUVAth\u00e9rapie n&#8217;a \u00e9t\u00e9 observ\u00e9, ni pendant la phase d&#8217;induction, ni pendant la phase d&#8217;entretien. Les auteurs concluent que l&#8217;\u00e9tude plaide en faveur d&#8217;une PUVAth\u00e9rapie et, en cas de r\u00e9ponse compl\u00e8te, d&#8217;un traitement d&#8217;entretien ult\u00e9rieur, et identifie deux biomarqueurs potentiels.<\/p>\n<p>Source : JAMA Dermatol 2019.<br \/>\nDOI: 10.1001\/jamadermatol.2018.5905.<\/p>\n<p>&nbsp;<\/p>\n<p><em>DERMATOLOGIE PRAXIS 2019 ; 29(4) : 4 (publi\u00e9 le 25.8.19, ahead of print)<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Des dermatologues ont montr\u00e9 dans une \u00e9tude multicentrique en Autriche qu&#8217;un traitement \u00e0 faible dose \u00e0 base de psoral\u00e8ne et de rayons UV-A (PUVA) n&#8217;entra\u00eene pas seulement une r\u00e9mission \u00e0&hellip;<\/p>\n","protected":false},"author":7,"featured_media":90717,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Mycosis fongo\u00efde","footnotes":""},"category":[11523,11362,11527,11549],"tags":[12731,28060],"powerkit_post_featured":[],"class_list":["post-335790","post","type-post","status-publish","format-standard","has-post-thumbnail","category-actualites","category-dermatologie-et-venerologie","category-etudes","category-rx-fr","tag-mycosis-fongoide","tag-puva-fr","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-21 00:36:27","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"fr_FR","wpml_translations":{"it_IT":{"locale":"it_IT","id":335797,"slug":"il-trattamento-puva-mostra-un-effetto-duraturo","post_title":"Il trattamento PUVA mostra un effetto duraturo","href":"https:\/\/medizinonline.com\/it\/il-trattamento-puva-mostra-un-effetto-duraturo\/"},"pt_PT":{"locale":"pt_PT","id":335806,"slug":"o-tratamento-puva-mostra-um-efeito-duradouro","post_title":"O tratamento PUVA mostra um efeito duradouro","href":"https:\/\/medizinonline.com\/pt-pt\/o-tratamento-puva-mostra-um-efeito-duradouro\/"},"es_ES":{"locale":"es_ES","id":335778,"slug":"el-tratamiento-puva-muestra-un-efecto-duradero","post_title":"El tratamiento PUVA muestra un efecto duradero","href":"https:\/\/medizinonline.com\/es\/el-tratamiento-puva-muestra-un-efecto-duradero\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/335790","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/comments?post=335790"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/335790\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media\/90717"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media?parent=335790"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/category?post=335790"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/tags?post=335790"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/powerkit_post_featured?post=335790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}