Narrowband ultraviolet B phototherapy is associated with a reduction in topical corticosteroid and clinical improvement in atopic dermatitis: a historical inception cohort study

Autor:	M. Owusu-Ayim, Sally H. Ibbotson, Robert S. Dawe, J.Y. Choi, John Foerster, C. Fleming
Rok vydání:	2021
Předmět:	Adult Male medicine.medical_specialty Adolescent Histamine Antagonists Administration Oral Dermatology Administration Cutaneous Dermatitis Atopic Narrowband ultraviolet B phototherapy Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Adrenal Cortex Hormones Internal medicine medicine Humans Prospective Studies Clinical efficacy Child Clinical treatment Retrospective Studies business.industry Infant Newborn Infant Ultraviolet b Atopic dermatitis medicine.disease INCEPTION COHORT Treatment Outcome Topical corticosteroid Child Preschool 030220 oncology & carcinogenesis Cohort Female Ultraviolet Therapy Dermatologic Agents business
Zdroj:	Clinical and Experimental Dermatology. 46:1067-1074
ISSN:	1365-2230 0307-6938
Popis:	BACKGROUND Despite decades of use, the magnitude of efficacy of narrowband ultraviolet B (NB-UVB) phototherapy for atopic dermatitis (AD) beyond industry-sponsored trials remains unclear. AIM To evaluate the clinical efficacy of NB-UVB in AD under real-world conditions. METHODS We conducted a historical inception cohort study using automated recording of dispensed drugs to provide an objective treatment outcome in a large population catchment of 420 000 people over 15 years. We analysed clinical treatment outcomes, recorded multicentre and prospectively over 15 years, of a large AD treatment cohort (n = 844), along with the drugs dispensed to this cohort. RESULTS The majority (70%) of patients with AD received significantly fewer topical corticosteroids (TCS) during the 12-month window after finishing NB-UVB compared with the 12-month window before starting the treatment (median reduction from 37.5 to 19.7 g/month). The number of patients dispensed with oral corticosteroids and antihistamines also dropped significantly (from 20% to 10% and from 69% to 31%, respectively), while all AD-unrelated drugs dispensed remained unchanged. Clinically, NB-UVB treatment achieved a 'clear' or 'almost clear' status in 48.7% of patients, while 20.4% achieved 'moderate clearance'. Treatment outcomes scores were validated by a strong correlation with reduction in AD-specific drug treatment. CONCLUSION Our data confirm the significant efficacy of NB-UVB for AD under conditions of routine care.
Databáze:	OpenAIRE
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