Definition of the Clinical Characteristics of Patients with Moderate and Severe Atopic Dermatitis for Whom Narrow-Band UVB (NB-UVB) and Medium-Dose UVA1 Phototherapies Are Still Valuable Treatment Options at the Age of Biologics
Abstract
:1. Introduction
2. Materials and Methods
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- The percentage of participants achieving an Investigator’s Global Assessment (IGA) score of 0 (clear) or 1 (almost clear) [18];
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- The percentage of patients achieving an IGA score of 0/1 without a relapse within 6 months from the end of treatment (EOT).
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- The median final EASI score;
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- The percentage of participants achieving EASI 75 (≥75% improvement from baseline EASI), EASI 50 (>50% to <75% improvement) and EASI 90 (>90% improvement);
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- The percentage of patients with an EASI improvement of <50%;
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- The percentage of patients with phototherapy-related adverse events;
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- The percentage of patients with phototherapy-related adverse events leading to treatment discontinuation.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patients Treated with Medium-Dose UVA1 | Patients Treated with NB-UVB | Comparisons of Patients’ Groups Treated in 2013–2017 or 2018–2022 with the 2 Phototherapies | ||||||
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Column | (a) | (b) | (a) vs. (b) | (c) | (d) | (c) vs. (d) | (a) vs. (c) | (b) vs. (d) |
2013–2017 | 2018–2022 | p | 2013–2017 | 2018–2022 | p | p | p | |
Number | 46 | 16 | 99 | 26 | ||||
Age (years), median (range) | 26.0 (7–67) | 24.5 (10–52) | NS | 31 (13–73) | 20.5 (14–66) | NS | NS | NS |
Gender | NS | NS | NS | NS | ||||
Male (%) | 12 (41.3%) | 5 (31.2%) | 64 (64.6%) | 11 (42.3%) | ||||
Female (%) | 27 (58.7%) | 11 (68.8%) | 35 (35.4%) | 15 (57.7%) | ||||
Boston skin phototype, n (%) | NS | NS | NS | NS | ||||
2 (%) | 12 (26.1%) | 5 (31.2%) | 22 (22.2%) | 7 (26.9%) | ||||
3 (%) | 21 (67.4%) | 10 (62.5%) | 67 (67.7%) | 15 (57.7%) | ||||
4 (%) | 3 (6.5%) | 1 (6.3%) | 10 (10.1%) | 4 (15.4%) | ||||
Medical history of AD | <0.001 | <0.001 | NS | NS | ||||
continuous AD, n (%) | 27 (58.7%) | 0 (0%) | 34 (34.3%) | 0 (0%) | ||||
intermittent AD *, n (%) | 19 (41.3%) | 16 (100%) | 65 (65.7%) | 26 (100%) | ||||
Number of treatment sessions [median (range)] | 30 (12–66) | 18.5 (12–26) | <0.01 | 33 (16–51) | 24 (12–30) | <0.001 | NS | NS |
Cumulative UV dose (J/cm2) [median (range)] | 1155.0 (360–3080) | 770 (230–1750) | <0.01 | 16.3 (0.6–30.8) | 11.3 (3.6–28.5) | 0.02 | ||
Patients with an IGA 0/1 result | 21 (46%) | 12 (75%) | 0.014 | 42 (42%) | 19 (73.1%) | 0.037 | NS | NS |
Patients with an IGA 0/1 persistent for at least 6 months | 15 (33%) | 11 (69%) | 0.012 | 28 (28%) | 18 (69.2%) | 0.016 | NS | NS |
Baseline median EASI (range) | 28.7 (8.7–52.2) | 18.7 (8.6–27.4) | <0.001 | 30.5 (7.9–52.2) | 18.4 (9.1–26.3) | <0.001 | NS | NS |
Final median EASI (range) ** | 9.9 (0.6–50.1) | 4.3 (0.3–19.0) | 0.006 | 13.7 (0–39.2) | 4.6 (1.4–34.4) | <0.001 | NS | NS |
Patients achieving EASI 90 | 4 (10.9%) | 5 (31.3%) | 0.027 | 11 (11%) | 9 (34.6%) | 0.041 | NS | NS |
Patients achieving EASI 75 | 15 (32.6%) | 7 (43.8%) | 0.02 | 28 (28.3%) | 6 (30.8%) | NS | NS | NS |
Patients with at least 1 adverse effect *** | 8 (17.4%) | 2 (12.5%) | NS | 0 | 0 | NS | NS | NS |
Baseline EASI | Clinical Course | Treated Number of Patients | IGA 0/1 Persistent for at Least 6 Months | Rate (%) of Patients Achieving Persistent IGA 0/1 | p |
---|---|---|---|---|---|
Patients treated with medium-dose UVA1 phototherapy (n = 46) | |||||
<24.4 | intermittent | 13 | 9 | 69.2% | <0.001 |
<24.4 | continuous | 2 | 1 | 50% | |
>24.5 | intermittent | 6 | 2 | 33.3% | |
>24.5 | continuous | 25 | 3 | 12% | |
Patients treated with NB-UVB phototherapy (n = 99) | |||||
<24.7 | intermittent | 26 | 19 | 73.1% | <0.001 |
<24.7 | continuous | 6 | 1 | 16.7% | |
>24.8 | intermittent | 8 | 2 | 25.0% | |
>24.8 | continuous | 59 | 6 | 10.2% |
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Rossi, M.; Damiani, C.; Arisi, M.; Tomasi, C.; Tonon, F.; Venturini, M.; Calzavara-Pinton, P. Definition of the Clinical Characteristics of Patients with Moderate and Severe Atopic Dermatitis for Whom Narrow-Band UVB (NB-UVB) and Medium-Dose UVA1 Phototherapies Are Still Valuable Treatment Options at the Age of Biologics. J. Clin. Med. 2023, 12, 3303. https://doi.org/10.3390/jcm12093303
Rossi M, Damiani C, Arisi M, Tomasi C, Tonon F, Venturini M, Calzavara-Pinton P. Definition of the Clinical Characteristics of Patients with Moderate and Severe Atopic Dermatitis for Whom Narrow-Band UVB (NB-UVB) and Medium-Dose UVA1 Phototherapies Are Still Valuable Treatment Options at the Age of Biologics. Journal of Clinical Medicine. 2023; 12(9):3303. https://doi.org/10.3390/jcm12093303
Chicago/Turabian StyleRossi, Mariateresa, Caterina Damiani, Mariachiara Arisi, Cesare Tomasi, Francesco Tonon, Marina Venturini, and Piergiacomo Calzavara-Pinton. 2023. "Definition of the Clinical Characteristics of Patients with Moderate and Severe Atopic Dermatitis for Whom Narrow-Band UVB (NB-UVB) and Medium-Dose UVA1 Phototherapies Are Still Valuable Treatment Options at the Age of Biologics" Journal of Clinical Medicine 12, no. 9: 3303. https://doi.org/10.3390/jcm12093303