Results:
This study was carried out on 60 patients with CLP; the mean age of all
included patients was 34.3 ± 2 years. There were no significant
differences between the patients in the two treatment groups regarding
age, sex, marital status, special habits, occupation, and residence
(P>0.05).
Regarding the level of clinical response; there were no significant
differences between NB-UVB group and MTX group (P=0.149). The level of
clinical response to the different treatment models was illustrated in
table 1. Among NB-UVB group, about two-thirds of cases (36.7% each)
showed either complete response to treatment or no response and only one
quarter (26.6%) showed partial response to treatment. For the MTX
group, half (50%) of cases showed partial response to treatment, about
one-third (30%) showed complete response and only one-fifth (20%) of
them showed no response to treatment. This relationship was a
statistically insignificant (P >0.05). Table 1, Fig
1, 2
Regarding level of TNF-α, there were no significant differences between
NB-UVB group and MTX group before treatment (P=0.147), while a
significant difference was between NB-UVB group and MTX group after
treatment (P=0.024). There were no statistically significant differences
between the two groups in the median TNF-α level before treatment
(P>0.05). Table 2
On the other hand, there were statistically significant differences
between the two groups in the median TNF-α levels after treatment
(P=0.024). Furthermore, for repeated measure analysis (before vs. after
treatment); the median level of TNF-α decreased significantly after
treatment in the MTX group by 12 pg/ml (P=0.001). Notwithstanding the
median TNF-α increased insignificantly after treatment in the NB-UVB
group by 1.5 pg/ml (P>0.05). In respect to the percent
change in the level of TNF-α in response to treatment, the level of
TNF-α decreased significantly after treatment in the MTX group by 41%
compared with only 0.8% in the NB-UVB group (P= 0.021). Table
2
In the NB-UVB group; a significant high positive correlation was between
TNF-α levels before and after treatment (r=0.60; P<0.001). In
the MTX group; there was a significant mild positive correlation between
TNF-α levels before and after treatment (r=0.22; P=0.039). In the NB-UVB
group; there was a significant high positive correlation between TNF-α
levels before and after treatment (r=0.60; P<0.001). In the
same way, In the MTX group; there was a significant mild positive
correlation between TNF-α levels before and after treatment (r=0.22;
P=0.039). Fig 3, 4
In the NB-UVB group; there were no statistically significant differences
in the median TNF-α levels between different clinical response groups
neither overall (P>0.05) nor pairwise (complete (35 (39)
pg/ml), partial (21 (33) pg/ml) and (40 (76) pg/ml), respectively. In
the MTX group; there was no statistically significant difference in the
median TNF-α levels between different clinical response groups neither
overall (P>0.05) nor pairwise (complete (20 (26) pg/ml),
partial (28 (16) pg/ml) and (25 (16) pg/ml), respectively. In respect to
the percent change in the level of TNF-α in response to treatment for
different clinical response levels, in the NB-UVB group; there was
statistically significant difference in the median percent change of
TNF-α levels between different clinical response groups overall (P=
0.016). For pairwise comparisons, patients with complete response had
2% changes vs. 22% change in cases with partial response and this was
statistically insignificant (P>0.05). Unlike, patients with
partial response had 22% change vs. -25% change in cases with no
response and this was a statistically significant (P=0.009). Likewise,
patients with complete response had 2% change vs. -25% change in cases
with no response and this was a statistically significant (P= 0.001).