Immunogenetic Profiling of Goeckerman Therapy in the Treatment of Psoriasis Vulgaris

NCT ID: NCT03662685

Last Updated: 2025-08-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE1

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-01

Study Completion Date

2024-05-31

Brief Summary

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This study examines the effect of Goeckerman therapy (a combination of phototherapy and topical crude coal tar), crude coal tar alone, and phototherapy alone on the immunologic and genetic environment within psoriatic skin lesions.

Detailed Description

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This is a three-arm, open-label study to examine the effect of Goeckerman therapy. Goeckerman therapy is known for its high efficacy and favorable safety profile in the treatment of psoriasis. It consists of a combination of phototherapy and topical crude coal tar). This study will examine how Goeckerman therapy, crude coal tar alone, and phototherapy alone affect the mmunologic and genetic environment within psoriatic skin lesions. Fifteen subjects with moderate to severe psoriasis will be enrolled. Biopsy samples will be collected and undergo molecular profiling to further elucidate the mechanism of action by which Goeckerman treatment improves psoriatic skin lesions.

Conditions

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Psoriasis Vulgaris Psoriasis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Goeckerman Therapy

Patients with psoriasis who will receive Goeckerman therapy 5 days per week for 6 weeks.

Group Type ACTIVE_COMPARATOR

Goeckerman Therapy

Intervention Type OTHER

The Goeckerman regimen consists of exposure to narrowband ultraviolet B (NB-UVB) light phototherapy and application of crude coal tar to the skin 5 days per week. The treatment will occur the UCSF outpatient skin treatment center for approximately 4-5 hours, 5 days a week for 6 weeks (total of 30 sessions). The treatment is consistent with the standard of care Goeckerman treatment protocol at UCSF.

Phototherapy Only

Patients with psoriasis who will receive narrowband ultraviolet B (NB-UVB) phototherapy 3 days per week for 12 weeks.

Group Type ACTIVE_COMPARATOR

Phototherapy Only

Intervention Type DEVICE

Light treatment with narrowband ultraviolet B (NB-UVB) phototherapy three days per week for 12 weeks at the UCSF Phototherapy Center per the standard UCSF phototherapy protocol, in which starting dose is based on the subject's Fitzpatrick skin type and gradually increased as tolerated. Each phototherapy treatment will last approximately from under 1 minute to less than 15 minutes.

Crude Coal Tar Only

Patients with psoriasis who will receive skin treatment with crude coal tar only 5 days per week for 6 weeks.

Group Type ACTIVE_COMPARATOR

Crude Coal Tar Only

Intervention Type DRUG

A topical medication consisting of crude coal tar will be applied to the psoriatic skin under plastic wrap occlusion for approximately up to 4-5 hours, 5 days a week for 6 weeks (total of 30 sessions), at the outpatient skin treatment center at UCSF.

Interventions

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Goeckerman Therapy

The Goeckerman regimen consists of exposure to narrowband ultraviolet B (NB-UVB) light phototherapy and application of crude coal tar to the skin 5 days per week. The treatment will occur the UCSF outpatient skin treatment center for approximately 4-5 hours, 5 days a week for 6 weeks (total of 30 sessions). The treatment is consistent with the standard of care Goeckerman treatment protocol at UCSF.

Intervention Type OTHER

Crude Coal Tar Only

A topical medication consisting of crude coal tar will be applied to the psoriatic skin under plastic wrap occlusion for approximately up to 4-5 hours, 5 days a week for 6 weeks (total of 30 sessions), at the outpatient skin treatment center at UCSF.

Intervention Type DRUG

Phototherapy Only

Light treatment with narrowband ultraviolet B (NB-UVB) phototherapy three days per week for 12 weeks at the UCSF Phototherapy Center per the standard UCSF phototherapy protocol, in which starting dose is based on the subject's Fitzpatrick skin type and gradually increased as tolerated. Each phototherapy treatment will last approximately from under 1 minute to less than 15 minutes.

Intervention Type DEVICE

Other Intervention Names

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Combination Treatment with Phototherapy and Crude Coal Tar Goeckerman Regimen Coal tar Ultraviolet B Narrowband ultraviolet B NB-UVB UVB phototherapy Phototherapy Light treatment

Eligibility Criteria

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Inclusion Criteria

1. Male or female ≥ 18 years of age at enrollment.
2. Documentation of predominately moderate to severe plaque psoriasis for at least 6 months prior to enrollment.
3. Written informed consent obtained from subject and ability for subject to comply with the requirements of the study.
4. Subject is considered a candidate for phototherapy or systemic therapy
5. Body Surface Area (BSA) ≥ 5%.
6. Physical exam within clinically acceptable limits.

Exclusion Criteria

1. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
2. Subject has predominantly non-plaque form of psoriasis.
3. Subject has drug-induced psoriasis.
4. Subject with current, or a history of, severe psoriatic arthritis well controlled on current therapy.
5. Patient has absolute or relative contraindication to phototherapy, including photosensitizing disorders.
6. Evidence of abnormality of any immune cell population from a drug-induced or genetic cause.
7. Known HIV positive status.
8. Known allergy to lidocaine, other local anesthetics, or any component of local anesthetic agents.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Psoriasis Foundation

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tina Bhutani, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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UCSF Psoriasis and Skin Treatment Center

San Francisco, California, United States

Site Status

Countries

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United States

References

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Gupta R, Debbaneh M, Butler D, Huynh M, Levin E, Leon A, Koo J, Liao W. The Goeckerman regimen for the treatment of moderate to severe psoriasis. J Vis Exp. 2013 Jul 11;(77):e50509. doi: 10.3791/50509.

Reference Type BACKGROUND
PMID: 23892536 (View on PubMed)

Menter A, Cram DL. The Goeckerman regimen in two psoriasis day care centers. J Am Acad Dermatol. 1983 Jul;9(1):59-65. doi: 10.1016/s0190-9622(83)70107-6.

Reference Type BACKGROUND
PMID: 6886105 (View on PubMed)

Moscaliuc ML, Heller MM, Lee ES, Koo J. Goeckerman therapy: a very effective, yet often forgotten treatment for severe generalized psoriasis. J Dermatolog Treat. 2013 Feb;24(1):34-7. doi: 10.3109/09546634.2012.658014. Epub 2012 Mar 4.

Reference Type BACKGROUND
PMID: 22329632 (View on PubMed)

van den Bogaard EH, Bergboer JG, Vonk-Bergers M, van Vlijmen-Willems IM, Hato SV, van der Valk PG, Schroder JM, Joosten I, Zeeuwen PL, Schalkwijk J. Coal tar induces AHR-dependent skin barrier repair in atopic dermatitis. J Clin Invest. 2013 Feb;123(2):917-27. doi: 10.1172/JCI65642. Epub 2013 Jan 25.

Reference Type BACKGROUND
PMID: 23348739 (View on PubMed)

Li B, Tsoi LC, Swindell WR, Gudjonsson JE, Tejasvi T, Johnston A, Ding J, Stuart PE, Xing X, Kochkodan JJ, Voorhees JJ, Kang HM, Nair RP, Abecasis GR, Elder JT. Transcriptome analysis of psoriasis in a large case-control sample: RNA-seq provides insights into disease mechanisms. J Invest Dermatol. 2014 Jul;134(7):1828-1838. doi: 10.1038/jid.2014.28. Epub 2014 Jan 17.

Reference Type BACKGROUND
PMID: 24441097 (View on PubMed)

Gupta R, Ahn R, Lai K, Mullins E, Debbaneh M, Dimon M, Arron S, Liao W. Landscape of Long Noncoding RNAs in Psoriatic and Healthy Skin. J Invest Dermatol. 2016 Mar;136(3):603-609. doi: 10.1016/j.jid.2015.12.009. Epub 2015 Dec 18.

Reference Type BACKGROUND
PMID: 27015450 (View on PubMed)

Sekhon S, Jeon C, Nakamura M, Afifi L, Yan D, Wu JJ, Liao W, Bhutani T. Review of the mechanism of action of coal tar in psoriasis. J Dermatolog Treat. 2018 May;29(3):230-232. doi: 10.1080/09546634.2017.1369494. Epub 2017 Sep 19.

Reference Type BACKGROUND
PMID: 28814117 (View on PubMed)

Zhu TH, Nakamura M, Farahnik B, Abrouk M, Singh RK, Lee KM, Hulse S, Koo J, Bhutani T, Liao W. The Patient's Guide to Psoriasis Treatment. Part 4: Goeckerman Therapy. Dermatol Ther (Heidelb). 2016 Sep;6(3):333-9. doi: 10.1007/s13555-016-0132-7. Epub 2016 Jul 29.

Reference Type BACKGROUND
PMID: 27474032 (View on PubMed)

Other Identifiers

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Goeckerman Immunogenetics

Identifier Type: -

Identifier Source: org_study_id

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