Evaluation of a multicentre study of synchronous application of narrowband ultraviolet B phototherapy (TL-01) and bathing in Dead Sea salt solution for psoriasis vulgaris

Abstract

The synchronous application of narrowband UVB phototherapy with 311 nm lamps (Philips TL-01) and bathing in Dead Sea salt solution was evaluated in a multicentre trial (n = 60) in outpatients suffering from psoriasis vulgaris. The study design consisted of an initial therapy phase of up to 35 treatments (three to five times a week) followed by maintenance therapy with up to 35 further applications (once or twice a week). Evaluation was performed separately for patients in according-to-protocol (ATP) (n = 280) and intention-to-treat (ITT) (n = 692) groups. An overall significant improvement of the Psoriasis Area and Severity Index (PASI) score (P < 0.05) could be shown for both groups during initial therapy with 71.4% improvement for ATP and 61% for ITT patients. The mean PASI for ATP (values for ITT in parentheses) was 17.7 (18.6) at baseline, 9.5 (10.7) after 20 applications and 5.2 (7.4) at the end of initial therapy. On average, ATP patients received 3.9 (3.5) applications per week with a cumulative irradiation dose of 19.5 J cm-2 (16.2 J cm-2). The most frequent side-effect was erythema, observed in 8.7% of the patients. Subjective evaluation of the therapy by the patients (n = 168) was excellent. Seventy-nine per cent of patients preferred the new treatment strategy in comparison with other previous therapies and 88% regarded this therapy as pleasant and comfortable. In conclusion, we could demonstrate a significant effect of therapy in both the ATP and the ITT groups for this new treatment system which imitates, as far as possible, the Dead Sea climatic conditions, with no severe side-effects and a high acceptance by the patients.

A review of phototherapy protocols for psoriasis treatment

“…By the end of the fourth week, a statistically significant response was observed with NB-UVB plus LCD versus NB-UVB alone. 80 Some studies support the use of balneotherapy in the treatment of psoriasis, 81 whereas others are skeptical. 55 Balneotherapy is the submersion of a patient in 5% to 15% magnesium-rich salt water with subsequent NB-UVB irradiation while the skin is still wet.…”

Follow-up analysis of circulating mononuclear cell CLA expression in patients with psoriasis

“…The 311 nm UVB light therapy is nowadays a first-choice treatment modality of the disease for patients with extended skin signs, synchronous balneophototherapy using these lamps is an effective method for the clearance of psoriatic skin symptoms [8,9].…”

“…Eleven patients with extended skin symptoms of psoriasis were treated by synchronous balneophototherapy [8,9]. The Psoriasis Area and Severity Index (PASI) was evaluated before, after the treatment and at a follow-up control visit after 4 months.…”

Psoriasistherapie

“…3, 5). Lediglich in einer Studie [25] finden sich für die kPST vergleichbare Zahlen: 6 Monate nach Therapie befanden sich bei der synchronen künstlichen Photosoletherapie noch 55% der Patienten in Remission, bei der nPST 43 bzw. 40% [26].…”