HOME-BASED narrowband UV-B phototherapy for plaque or guttate psoriasis is just as effective as office-based treatment according to a recent randomised clinical trial led by Joel M. Gelfand, University of Pennsylvania, USA. The study, which involved 783 patients aged 12 and over, compared the two approaches across a range of skin tones and found no significant differences in patient or physician-reported outcomes. Home-based treatment also reduced indirect costs and had better adherence, making it a compelling option for psoriasis patients.
The trial took place in 42 dermatology practices across the US, enrolling participants between 2019 and 2023. Patients were randomised to receive either a home-based UV-B machine or routine office-based phototherapy for 12 weeks, followed by another 12-week observation period. Two key outcomes were measured: the Physician Global Assessment of clear or almost clear skin, and the Dermatology Life Quality Index, which assesses the impact of skin conditions on quality of life.
At the end of the 12-week treatment period, 32.8% of patients receiving home-based phototherapy achieved clear or almost clear skin, compared to 25.6% of those treated in office settings. Similarly, 52.4% of home-treated patients saw improvements in their quality of life, compared to 33.6% of office-treated patients. The study found no difference in efficacy between the two groups across different skin types.
Notably, the home-based phototherapy group had better treatment adherence, with 51.4% of participants completing their therapy, compared to just 15.9% in the office-based group. Home treatment was also associated with a lower burden of indirect costs, such as travel expenses and time off work, though it did have a slightly higher incidence of mild, persistent erythema.
Overall, this trial highlights that home-based UV-B phototherapy is a highly effective, convenient, and cost-efficient alternative to office-based treatments for psoriasis, making it a viable option for many patients.
Katie Wright, EMJ
Reference
Gelfand JM et al. Home- vs office-based narrowband uv-b phototherapy for patients with psoriasis: the LITE randomized clinical trial. JAMA Dermatol. 2024;DOI:10.1001/jamadermatol.2024.3897.
