Photo Credit: Iri-s
Research published in JAMA Dermatology indicated that home-based phototherapy was as effective as office-based phototherapy for patients with psoriasis.
Clinicians are gearing up to attend the upcoming 2025 Winter Clinical in Hawaii. Meeting chair April W. Armstrong, MD, MPH, will participate in several sessions related to psoriasis therapeutics and management, including the following:
- Chew on This: Late Breakers in Psoriasis Oral Therapies
- 60 Tips in 60 Minutes – Day 1: Psoriasis, Urticaria, Infection, Skin Cancer, HS, and Office Management
- Wisdom and Therapeutic Advice in Psoriasis
Previously, Dr. Armstrong and colleagues investigated whether home-based phototherapy was as effective as office-based phototherapy for patients with psoriasis.
“Office-based phototherapy is cost-effective for psoriasis but difficult to access,” Dr. Armstrong and colleagues wrote in JAMA Dermatology. “Home-based phototherapy is patient preferred but has limited clinical data, particularly in patients with darker skin.”
The LITE Study
The researchers conducted an open-label, multicenter, randomized clinical trial called the Light Treatment Effectiveness (LITE) study.
The study involved 783 patients receiving routine care at 42 academic and private dermatology clinics across the United States. Participants were aged an average 48.0 years (SD, 15.5), and just under half (n=376; 48.0%) were male.
The patients were randomly assigned to use a home narrowband UV-B machine with guided mode dosimetry (n=393) or office-based narrowband UV-B (n=390) for 12 weeks. After treatment, patients underwent 12 weeks of observation.
The investigators noted that 350 (44.7%) of patients had skin phototype I/II, 350 (44.7% had III/IV, and 83 (10.6%) had V/VI. Some 93 (11.9%) patients were on systemic therapies throughout the study.
The primary outcomes were Physician Global Assessment (PGA) scores of 1 or lower, which indicate clear or almost clear skin, and Dermatology Life Quality Index (DLQI) scores of 5 or lower, indicating minimal or no effect on QOL.
Lower Costs & Better Adherence
The average baseline PGA and DLQI scores were 2.7 (0.8) and 12.2 (7.2), respectively. After 12 weeks of treatment, 32.8% (n=129) of patients in the home-based group and 25.6% (n=100) of those in the office-based group had clear or almost clear skin. Additionally, DLQI scores indicated that 52.4% (n=206) of those in the home-based group and 33.6% (n=131) of those in the office-based group experienced little to no impact on QOL.
Home-based administration was also associated with significantly better adherence (51.4% vs 15.9%; P<0.001), lower indirect costs for patients, and higher rates of persistent erythema (5.9% vs 1.2% of treatments; P<0.001).
No patients in either group discontinued treatment due to AEs.
“Home-based phototherapy was noninferior to office-based phototherapy across all skin tones for physician- and patient-reported outcomes and was associated with a lower burden of indirect costs to patients,” the researchers concluded.
