Abstract
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. To evaluate the clinical efficacy of NB-UVB in AD under real-world conditions. 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 420000 people over 15years. We analysed clinical treatment outcomes, recorded multicentre and prospectively over 15years, of a large AD treatment cohort (n=844), along with the drugs dispensed to this cohort. 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 19.7g/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. Our data confirm the significant efficacy of NB-UVB for AD under conditions of routine care.
Highlights
The population in Tayside in Scotland receives near-complete provision of healthcare organized by a single provider that offers resources addressing these limitations, including automated capture of all prescription drugs, prospectively collected narrowband ultraviolet B (NB-UVB) treatment outcomes, electronic recording of specialistvalidated diagnoses and review status for all patients referred for treatment from primary care in a a 2021 The Authors
We previously reported on the clinical characteristics of patients with atopic dermatitis (AD) not controlled in primary care, along with the amounts of topical corticosteroids (TCS) and emollients dispensed to these patients.[11]
Data on dispensed drugs were gathered from Health Informatic Centre Tayside, while clinical outcomes of NB-UVB therapy, rated by both phototherapy nurses and patients combined, were collected using datasets derived from the Photosys database at four independent treatment sites
Summary
Narrowband ultraviolet B (NB-UVB) has been in use for atopic dermatitis (AD) for decades, and its efficacy has been confirmed in randomized controlled trials.[1,2] data on efficacy beyond formal studies are limited to small studies or case series,[1,2,3,4] some focused only on children,[5,6,7,8,9] and a lack of information on Conflict of interest: the authors declare that they have no conflicts of interest.Accepted for publication 7 April 2021 efficacy under real-world conditions is well recognized.[10]. Narrowband ultraviolet B (NB-UVB) has been in use for atopic dermatitis (AD) for decades, and its efficacy has been confirmed in randomized controlled trials.[1,2] data on efficacy beyond formal studies are limited to small studies or case series,[1,2,3,4] some focused only on children,[5,6,7,8,9] and a lack of information on Conflict of interest: the authors declare that they have no conflicts of interest. The population in Tayside in Scotland receives near-complete provision of healthcare organized by a single provider (the National Health Service) that offers resources addressing these limitations, including automated capture of all prescription drugs, prospectively collected NB-UVB treatment outcomes, electronic recording of specialistvalidated diagnoses and review status for all patients referred for treatment from primary care in a a 2021 The Authors.
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