TY - JOUR
T1 - Phototherapy for atopic dermatitis
T2 - A survey of European practice
AU - Steyn, M.
AU - Gerbens, L. A.A.
AU - Spuls, P. I.
AU - Mashayekhi, S.
AU - Deleuran, M.
AU - Barbarot, S.
AU - Wollenberg, A.
AU - Ferguson, J.
AU - Ibbotson, S.
AU - Flohr, C.
N1 - Funding Information:
MS has no conflict of interest to declare. LG is one of the chief investigators of the Dutch photo‐ and systemic therapy atopic eczema registry (TREAT NL) for adults and children, and one of the chief investigators of the Dutch Uvb Phototherapy, Dermatology ATopic Eczema (UPDATE) trial. PS received a departmental independent research grant for the TREAT NL registry from Pharma since December 2019, is involved in performing clinical trials with many pharmaceutical industries that manufacture drugs used for the treatment of, for example, psoriasis and atopic dermatitis, for which financial compensation is paid to the department/hospital, is Chief Investigator (CI) of the systemic and phototherapy atopic eczema registry (TREAT NL) for adults and children and was involved in the development of one of the HOME core outcome instruments (Recap of atopic eczema (RECAP)). SM has no conflict interest to declare. MD is an advisor, speaker and/or investigator for AbbVie, Pierre Fabre, La Roche Posay, Leo Pharma, Lilly, Incyte, Sanofi Genzyme, Regeneron, Kymab and Pfizer. SB is the head of the French Atopic Dermatitis Network (FCRIN) and is an investigator or speaker for Astrazeneca, Almirall, Sanofi‐Genzyme, Abbvie, Galderma, Alexion, Novartis, Janssen, Leo‐Pharma, Pfizer, Eli Lilly, UCB Pharma and Chiesi. AW has served as an advisor or paid speaker for, or participated in clinical trials sponsored by, Abbvie, Aileens, Almirall, Amgen, Beiersdorf, Bioderma, Bioproject, BMS, Chugai, Galapagos, Galderma, Glenmark, GSK, Hans Karrer, Janssen, Leo Pharma, Eli Lilly, L'Oreal, Maruho, MedImmune, MSD, Mylan, Novartis, Pfizer, Pierre Fabre, Regeneron, Sandoz, Santen, Sanofi‐Aventis and UCB unrelated to the content of this manuscript. JF is a paid advisor to INCYTE. He has contributed to funded research for Pfizer on vitiligo and skin cancer risk, is the CI in the UK for Pfizer's upcoming trial examining the benefits of ritlecitinib for vitiligo patients and is also responsible for the LA Roche Posay Photobiology Scholarship for the BPG. He is the CI for an NIHR‐registered registry, the Vitiligo Registry and Bioreseource (VOICE) funded by the British Skin Foundation. SI has no conflicts of interest to declare. CF is CI of the UK National Institute for Health Research‐funded TREAT (ISRCTN15837754) and SOFTER ( Clinicaltrials.gov : NCT03270566) trials as well as the UK‐Irish Atopic eczema Systemic Therapy Register (A‐STAR; ISRCTN11210918) and a principal investigator in the European Union (EU) Horizon 2020‐funded BIOMAP Consortium ( http://www.biomap‐imi.eu/ ). He also leads the EU Trans‐Foods consortium. His department has received funding from Sanofi‐Genzyme and Pfizer for skin microbiome work. He has also received compensation from the (reviewer and Section Editor) and EuroGuiDerm (guidelines lead). British Journal of Dermatology
Publisher Copyright:
© 2023 European Academy of Dermatology and Venereology.
PY - 2024/3
Y1 - 2024/3
N2 - Background: Phototherapy is used to treat atopic dermatitis (AD). Evidence for its efficacy, impact on quality of life, cost-effectiveness and short- and long-term safety with real-life usage is weak. Objectives: We established a taskforce to examine how phototherapy is currently being used as a treatment for AD across the United Kingdom and Europe to inform our understanding and guide future research into management of patients with AD using UV-based phototherapies. Methods: An anonymous electronic multiple-response survey exploring phototherapy prescribing practices and experience of phototherapy modalities was developed by the study authors and sent to members of phototherapy networks from the United Kingdom and Europe. Responses were received between February and July 2021. Results: About 144 respondents from 27 European countries completed the survey. NBUVB was the most widely used [n = 138 (96%)]. Home-based NBUVB was available in 8/27 countries (25/144 respondents, 17%). Oral psoralen-UVA (PUVA) was more widely available than bath PUVA (n = 106, 74% vs. n = 60, 42%) and used mainly in adult patients. 49/144 (34%) of respondents had access to UVA1. Phototherapy would be considered instead of systemic treatment in 96% of adults and 82% of children for NBUVB, versus 40% of adults and 3% of children for PUVA. Starting doses, standard dosing increments, length of treatment courses, lifetime limits for treatments and thresholds for performing annual skin assessments varied between responders. Conclusions: NBUVB was the most widely used phototherapy for AD in adult and paediatric patients, while PUVA and UVA1 were less used. Prescribing practices varied considerably, highlighting the lack of consensus practice in many different aspects of phototherapy for the treatment of AD in children and adults. This indicates that further studies are required to determine optimal phototherapeutic regimens for AD and informs our understanding of parameters that should be included in future high-quality randomized controlled trials (RCT) of phototherapy.
AB - Background: Phototherapy is used to treat atopic dermatitis (AD). Evidence for its efficacy, impact on quality of life, cost-effectiveness and short- and long-term safety with real-life usage is weak. Objectives: We established a taskforce to examine how phototherapy is currently being used as a treatment for AD across the United Kingdom and Europe to inform our understanding and guide future research into management of patients with AD using UV-based phototherapies. Methods: An anonymous electronic multiple-response survey exploring phototherapy prescribing practices and experience of phototherapy modalities was developed by the study authors and sent to members of phototherapy networks from the United Kingdom and Europe. Responses were received between February and July 2021. Results: About 144 respondents from 27 European countries completed the survey. NBUVB was the most widely used [n = 138 (96%)]. Home-based NBUVB was available in 8/27 countries (25/144 respondents, 17%). Oral psoralen-UVA (PUVA) was more widely available than bath PUVA (n = 106, 74% vs. n = 60, 42%) and used mainly in adult patients. 49/144 (34%) of respondents had access to UVA1. Phototherapy would be considered instead of systemic treatment in 96% of adults and 82% of children for NBUVB, versus 40% of adults and 3% of children for PUVA. Starting doses, standard dosing increments, length of treatment courses, lifetime limits for treatments and thresholds for performing annual skin assessments varied between responders. Conclusions: NBUVB was the most widely used phototherapy for AD in adult and paediatric patients, while PUVA and UVA1 were less used. Prescribing practices varied considerably, highlighting the lack of consensus practice in many different aspects of phototherapy for the treatment of AD in children and adults. This indicates that further studies are required to determine optimal phototherapeutic regimens for AD and informs our understanding of parameters that should be included in future high-quality randomized controlled trials (RCT) of phototherapy.
UR - http://www.scopus.com/inward/record.url?scp=85177829050&partnerID=8YFLogxK
U2 - 10.1111/jdv.19638
DO - 10.1111/jdv.19638
M3 - Article
C2 - 38011002
AN - SCOPUS:85177829050
SN - 0926-9959
VL - 38
SP - 521
EP - 529
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
IS - 3
ER -