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Narrowband UVB treatment is highly effective and causes a strong reduction in the use of steroid and other creams in psoriasis patients in clinical practice

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Date
03/08/2017
Author
Foerster, John
Boswell, Kirsty
West, Jonathan
Cameron, Heather
Fleming, Colin
Ibbotson, Sally
Dawe, Robert
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Drug Prescriptions
RL Dermatology
RM Therapeutics. Pharmacology
NDAS
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Abstract
BACKGROUND: Narrowband NB-UVB phototherapy (NB-UVB) is an effective treatment for psoriasis, as demonstrated by clinical trials. However, due to required infrastructure and need for treatment attendance opinions on the value of offering this treatment in routine practice vary. AIMS: To provide high quality large-scale and long-term data on the efficacy of NB-UVB for psoriasis under real-world conditions in order to assist in management decisions. METHODS: The following resources were employed: (1) complete and prospectively recorded prescription drug records for a population of 420,000 marked by low demographic mobility, (2) prospectively recorded clinical treatment outcomes for all NB-UVB treatment episodes occurring in the local population; (3) complete dermatology electronic treatment records of all psoriasis patients, allowing cross-validation of diagnoses and treatment records. Using these data sets, we analysed all first-ever initial NB-UVB treatment episodes occurring over 79 months (n = 1749) for both clinical outcomes and the effect of NB-UVB on the use of topical treatments for psoriasis. RESULTS: Around 75% of patients both achieved a status of "clear/minimal disease" and used fewer topical treatments. NB-UVB treatment led to a strong reduction for both steroid creams (25%) and psoriasis-specific topicals, e.g. vitamin-D products (30%) during the 12-month period following NB-UVB treatment. The effects measured were specific as no effect of NB-UVB was noted on drug prescriptions unrelated to psoriasis. Results were independent of individuals administering and/or scoring treatment, as they were highly similar between four geographically separate locations. CONCLUSIONS: NB-UVB treatment is highly effective and leads to a remarkable reduction in the need for topical cream treatments for a period of at least 12 months.
Citation
Foerster , J , Boswell , K , West , J , Cameron , H , Fleming , C , Ibbotson , S & Dawe , R 2017 , ' Narrowband UVB treatment is highly effective and causes a strong reduction in the use of steroid and other creams in psoriasis patients in clinical practice ' , PLoS ONE , vol. 12 , no. 8 , e0181813 . https://doi.org/10.1371/journal.pone.0181813
Publication
PLoS ONE
Status
Peer reviewed
DOI
https://doi.org/10.1371/journal.pone.0181813
ISSN
1932-6203
Type
Journal article
Rights
©2017 Foerster et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/18304

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