Efficacy of NB-UVB as Add-on Therapy to Antihistamine in the Treatment of Chronic Urticaria: A Systematic Review and Meta-analysis

Abstract

Introduction: Narrow-band ultraviolet B (NB-UVB) phototherapy has been used for the treatment of chronic urticaria (CU), but the clinical efficacy of this treatment modality requires further evidence. A systematic review and meta-analysis of randomized clinical trials were conducted to evaluate the efficacy and safety of NB-UVB as add-on therapy in the treatment of CU. Methods: A literature search was conducted in the Cochrane, Embase, PubMed, Web of Science, CNKI, CBM, VIP and WanFang databases up to October 2020. A total of nine studies involving 713 participants met the inclusion criteria. Results: Two trials showed a significant difference in the Urticaria Activity Score between therapy with NB-UVB ? antihistamines and that with antihistamines alone (mean difference 8.23, 95% confidence interval [CI] 5.78-10.68, p \ 0.00001). Six trials (563 participants) showed a significant benefit of NB-UVB as add-on therapy to antihistamines in the total effective rate (risk ratio [RR] 1.56, 95% CI 1.39-1.75, p \ 0.00001). In terms of adverse events, no statistically significant differences were found for NB-UVB ? antihistamines versus antihistamines alone (RR 1.10, 95% CI 0.67-1.79, p = 0.71). Combination therapy of NB-UVB ? antihistamines yielded a significantly lower risk of recurrence (RR 0.25, 95% CI 0.14-0.44, p \ 0.00001). Conclusion: Our meta-analysis suggests that combination therapy of NB-UVB ? antihistamines is significantly more effective in treating CU than antihistamines alone.