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Study heralds brighter future for psoriasis treatment

14 May 2009

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It would be helpful, following this research, to review the guidelines on the provision of UVB therapy. Gladys Edwards, Chief Executive, Psoriasis Association

More people with the skin condition psoriasis could benefit from ultraviolet B (UVB) light therapy, after new research published in medical journal the BMJ found that having the treatment at home was just as effective and safe as having it in hospital.

UVB therapy is an established treatment for people with psoriasis who haven't responded to treatment with medicated creams, or who have numerous scattered patches of psoriasis on their skin (such as in guttate psoriasis). However, in the UK the treatment is only usually administered in phototherapy units, which requires patients to go to hospital two or three times a week for several weeks. This means UVB therapy is often restricted to patients who live near a large hospital where the therapy is offered. It isn't currently offered as a home-based therapy to patients in the UK, due to concerns it may be less effective, and could be unsafe.

In the current trial, researchers in the Netherlands randomised 196 psoriasis patients to receive UVB therapy either at home or in a hospital. The extent and severity of the patients' condition following treatment was assessed by an independent research nurse and by self-assessment.

The therapy was found to be equally effective, whichever setting it was given in. For instance, around seven in 10 people had an improvement of at least 50 percent in the severity of their disease following treatment, whether this was in a hospital setting or at home. When patients assessed their own disease severity, this figure rose to eight in 10 for each group.

The researchers didn't find a difference in the safety of the therapy, no matter whether people received it at home or in hospital, with similar proportions of people reporting side effects such as blistering, burning sensation and skin redness.

Patients who could have their treatment at home believed that the treatment had less impact on their lives, and were also more likely to rate their treatment positively than those who had to come into hospital.

Gladys Edwards, Chief Executive of the Psoriasis Association told the Bupa health information team: "It would be helpful, following this research, to review the guidelines on the provision of UVB therapy. Patient choice is important and for some patients managing their UV treatment at home would clearly be preferable."

She added: "It is crucial, however, that there is absolutely clear guidance and information on when this is appropriate and how it should be managed for patients and clinicians."

Key findings

  • No matter where patients received their treatment, around seven in 10 had an improvement of 50 percent or more in disease extent and severity as assessed by an independent nurse, four in 10 had an improvement of 75 percent or more, and two in 10 had an improvement of 90 percent or more.
  • When patients self-assessed their disease severity, these figures were higher, with more patients reporting improvements of 75 percent or more and 90 percent or more in the group receiving treatment at home.
  • The average scores for disease extent and severity, as assessed by patients themselves, dropped by around 80 percent in both groups.
  • Quality of life improved following treatment by a similar amount in each group.