BACKGROUND: There is a lack of sufficiently large randomized trials evaluating the effectiveness of saline spa balneophototherapy compared to ultraviolet B (UVB) only. OBJECTIVE: The study aimed to evaluate whether highly concentrated saline spa water baths followed by UVB (HC-SSW-UVB) are superior to UVB only in moderate to severe psoriasis. METHODS:One hundred and sixty (160) adults with a Psoriasis Area and Severity Index (PASI) of >10 from 4 German spa centers were randomly allocated to HC-SSW-UVB (local sodium chloride concentration between 25% and 27%) or UVB only 3 a week until remission (PASI < 5) or for a maximum of 6 weeks. Reduction of PASI > or = 50% (PASI-50) at the end of the intervention period was defined as primary outcome. Only persons receiving at least 1 intervention were included into the primary analysis. RESULTS: Participants allocated to HC-SSW-UVB attained to a statistically significantly higher rate of PASI-50 than patients allocated to UVB only (68/79 [86%] versus 38/71 [54%]; p < 0.001; number needed to treat, 3.1; 95% confidence interval, 2.1-6.0). Postintervention analysis did not yield a clear hint of a persisting effect. CONCLUSIONS: The study indicates that HC-SSW-UVB are superior to routine UVB at the end of a 6-week treatment course.
RCT Entities:
BACKGROUND: There is a lack of sufficiently large randomized trials evaluating the effectiveness of salinespa balneophototherapy compared to ultraviolet B (UVB) only. OBJECTIVE: The study aimed to evaluate whether highly concentrated salinespawater baths followed by UVB (HC-SSW-UVB) are superior to UVB only in moderate to severe psoriasis. METHODS: One hundred and sixty (160) adults with a Psoriasis Area and Severity Index (PASI) of >10 from 4 German spa centers were randomly allocated to HC-SSW-UVB (local sodium chloride concentration between 25% and 27%) or UVB only 3 a week until remission (PASI < 5) or for a maximum of 6 weeks. Reduction of PASI > or = 50% (PASI-50) at the end of the intervention period was defined as primary outcome. Only persons receiving at least 1 intervention were included into the primary analysis. RESULTS:Participants allocated to HC-SSW-UVB attained to a statistically significantly higher rate of PASI-50 than patients allocated to UVB only (68/79 [86%] versus 38/71 [54%]; p < 0.001; number needed to treat, 3.1; 95% confidence interval, 2.1-6.0). Postintervention analysis did not yield a clear hint of a persisting effect. CONCLUSIONS: The study indicates that HC-SSW-UVB are superior to routine UVB at the end of a 6-week treatment course.
Authors: Frank Peinemann; Marco Harari; Sandra Peternel; Thalia Chan; David Chan; Alexander M Labeit; Thilo Gambichler Journal: Cochrane Database Syst Rev Date: 2020-05-05