At-home phototherapy noninferior to office-based treatment for psoriasis
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Key takeaways:
- The LITE study compared at-home and in-office phototherapy in more than 750 patients with psoriasis across all skin types.
- Topline results found in-home treatment to be efficacious regardless of skin type.
Patients with plaque or guttate psoriasis treated with at-home phototherapy experienced similar benefits to those treated in-office, according to topline study data.
The pragmatic, randomized, active comparator Light Treatment Effectiveness (LITE) study evaluated the two treatments in 783 patients across 42 treatment centers.
Patients with plaque or guttate psoriasis were treated with home or office-based narrowband ultraviolet phototherapy for 12 weeks.
“The data were definitive enough that the research team feels like it indicates home phototherapy can be considered a first-line treatment option for plaque or guttate psoriasis, which has major implications for patient care and health policy,” Joel M. Gelfand, MD, MSCE, James J. Leyden Professor of Dermatology & Epidemiology at Perelman School of Medicine at the University of Pennsylvania and the study’s principal investigator, told Healio. “We have a lot of options in psoriasis, but people still need a variety of options to control this chronic, incurable disease.”
Home phototherapy uses the same narrow band 311 ultraviolet bulbs as in-office models, according to a National Psoriasis Foundation press release. These bulbs vary from commercial tanning beds, which use a different wavelength in the UVA spectrum, and are generally not recommended for treatment of psoriasis..
The LITE study, funded by the Patient Centered Outcomes Research Institute, was designed to include a diverse range of patients with skin types I to VI. Ultimately, the study found in-home phototherapy to be efficacious in all skin types.
It was important to determine if at-home phototherapy could cause problems with burns, be tolerated in fair skin and show efficacy in darker skin.
“In recent years people have started to understand how important it is to be inclusive in clinical studies, to improve health equity, and this is something we’ve been working on for a long time in my research program,” Gelfand said. “By designing the study with diversity in mind, we were able to prove [at-home phototherapy] works great in all skin types.”
The pragmatic nature of the study, with input from shareholders including payers, aimed to generate data that would allow patients, clinicians and payers to determine real-world implications of different treatment modalities.
While office-based phototherapy has long been touted as an efficacious psoriasis treatment option, it does present barriers to care such as copays and travel time and expenses.
“It’s really important that health systems and insurance companies lower barriers for patients to get access to care,” Gelfand said. “Patient-centered care always needs to be our priority. Phototherapy is a really important treatment modality for our patients and being able to offer it in the office or at home is important for the practice of dermatology.”
Full study results will be presented at the American Academy of Dermatology Annual Meeting in San Diego on Saturday, March 9, during the late-breaking research program.
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