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Randomized Controlled Trial
. 2024 Dec 1;160(12):1320-1328.
doi: 10.1001/jamadermatol.2024.3897.

Home- vs Office-Based Narrowband UV-B Phototherapy for Patients With Psoriasis: The LITE Randomized Clinical Trial

Joel M Gelfand  1   2 , April W Armstrong  3 , Henry W Lim  4 , Steven R Feldman  5 , Sandra M Johnson  6 , W C Cole Claiborne  7 , Robert E Kalb  8 , Jeannette Jakus  9 , Aaron R Mangold  10 , R Hal Flowers  11 , Tina Bhutani  12 , John R Durkin  13 , Jerry Bagel  14 , Scott Fretzin  15 , Michael P Sheehan  16 , James Krell  17 , Margo Reeder  18 , Jessica Kaffenberger  19 , Francisca Kartono  20 , Junko Takeshita  1   2 , Alisha M Bridges  21 , Eric Fielding  22 , Umbereen S Nehal  23 , Kenneth L Schaecher  24 , Leah M Howard  25 , Guy S Eakin  25 , Suzette Báez  1 , Brooke E Bishop  1 , Robert C Fitzsimmons Jr  1 , Maryte Papadopoulos  1 , William B Song  1 , Kristin A Linn  2 , Rebecca A Hubbard  2   26 , Daniel B Shin  1 , Kristina Callis Duffin  27
Affiliations
Randomized Controlled Trial

Home- vs Office-Based Narrowband UV-B Phototherapy for Patients With Psoriasis: The LITE Randomized Clinical Trial

Joel M Gelfand et al. JAMA Dermatol. .

Erratum in

  • Errors in Abstract, Results, and Table 1.
    [No authors listed] [No authors listed] JAMA Dermatol. 2025 Mar 1;161(3):342. doi: 10.1001/jamadermatol.2024.6431. JAMA Dermatol. 2025. PMID: 39878967 Free PMC article. No abstract available.

Abstract

Importance: Office-based phototherapy is cost-effective for psoriasis but difficult to access. Home-based phototherapy is patient preferred but has limited clinical data, particularly in patients with darker skin.

Objective: To compare the effectiveness of home- vs office-based narrowband UV-B phototherapy for psoriasis.

Design, setting, and participants: The Light Treatment Effectiveness study was an investigator-initiated, pragmatic, open-label, parallel-group, multicenter, noninferiority randomized clinical trial embedded in routine care at 42 academic and private clinical dermatology practices in the US. Enrollment occurred from March 1, 2019, to December 4, 2023, with follow-up through June 2024. Participants were 12 years and older with plaque or guttate psoriasis who were candidates for home- and office-based phototherapy.

Interventions: Participants were randomized to receive a home narrowband UV-B machine with guided mode dosimetry or routine care with office-based narrowband UV-B for 12 weeks, followed by an additional 12-week observation period.

Main outcomes and measures: The coprimary effectiveness outcomes were Physician Global Assessment (PGA) dichotomized as clear/almost clear skin (score of ≤1) at the end of the intervention period and Dermatology Life Quality Index (DLQI) score of 5 or lower (no to small effect on quality of life) at week 12.

Results: Of 783 patients enrolled (mean [SD] age, 48.0 [15.5] years; 376 [48.0%] female), 393 received home-based phototherapy and 390 received office-based phototherapy, with 350 (44.7%) having skin phototype (SPT) I/II, 350 (44.7%) having SPT III/IV, and 83 (10.6%) having SPT V/VI. A total of 93 patients (11.9%) were receiving systemic treatment. At baseline, mean (SD) PGA was 2.7 (0.8) and DLQI was 12.2 (7.2). At week 12, 129 patients (32.8%) receiving home-based phototherapy and 100 patients (25.6%) receiving office-based phototherapy achieved clear/almost clear skin, and 206 (52.4%) and 131 (33.6%) achieved DLQI of 5 or lower, respectively. Home-based phototherapy was noninferior to office-based phototherapy for PGA and DLQI in the overall population and across all SPTs. Home-based phototherapy, compared to office-based phototherapy, was associated with better treatment adherence (202 patients [51.4%] vs 62 patients [15.9%]; P < .001), lower burden of indirect costs to patients, and more episodes of persistent erythema (466 of 7957 treatments [5.9%] vs 46 of 3934 treatments [1.2%]; P < .001). Both treatments were well tolerated with no discontinuations due to adverse events.

Conclusions and relevance: In this randomized clinical trial, home-based phototherapy was as effective as office-based phototherapy for plaque or guttate psoriasis in everyday clinical practice and had less burden to patients.

Trial registration: ClinicalTrials.gov Identifier: NCT03726489.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Gelfand reported receiving honoraria for serving as a consultant for AbbVie, Artax, BMS, Boehringer Ingelheim, Celldex, FIDE (which is sponsored by multiple pharmaceutical companies), GSK, Inmagene, Lilly, Leo Pharma, Moonlake, Janssen Biologics, Novartis, Oruka, UCB, Neuroderm, and Veolia North America; receiving research grants to the trustees of the University of Pennsylvania from Amgen, BMS, and Pfizer; receiving payment for continuing medical education work related to psoriasis that was supported indirectly by pharmaceutical sponsors; coholding a patent for resiquimod for treatment of cutaneous T-cell lymphoma; serving as Deputy Editor for the Journal of Investigative Dermatology and receiving honoraria from the Society for Investigative Dermatology; serving as Chief Medical Editor for Healio Dermatology and receiving honoraria; and serving as a member of the board of directors for the International Psoriasis Council and the Medical Dermatology Society, receiving no honoraria. Dr Armstrong reported receiving grants from AbbVie, Aslan, BMS, Dermavant Sciences, Dermira, Lilly, Galderma, Incyte, Janssen; Leo Pharma, Meiji Seika Pharma, Modernizing Medicine, Nimbus Therapeutics, Novartis, Ortho Dermatologics, Pfizer, Sanofi/Genzyme, UCB, and Ventyx Biosciences; receiving personal fees from AbbVie, Aslan, Almirall, Amgen, Arcutis, Beiersdorf, BMS, Dermavant, EPI Health, Lilly, Janssen, Leo Pharma, Mindera, Nimbus, Organon, Sanofi, Sun Pharma, Takeda, Ventyx Biosciences, Galderma, Incyte, Regeneron, and UCB; receiving other support from Boehringer Ingelheim; and serving on the Parexel Data Safety Monitoring Board outside the submitted work. Dr Lim reported grants from Incyte, La Roche-Posay, and Pfizer as well as personal fees from ISDIN, Beiersdorf, Ferndale, L’Oréal, Lilly, Zerigo, Skinosive, La Roche-Posay, Cantabria Labs, Pierre Fabre, NAOS, Uriage, and Pfizer outside the submitted work. Dr Feldman reported receiving research, speaking, and/or consulting support from Lilly, GlaxoSmithKline/Stiefel, AbbVie, Janssen, Alvotech, vTv Therapeutics, Bristol Myers Squibb, Samsung, Pfizer, Boehringer Ingelheim, Amgen, Dermavant, Arcutis, Novartis, Novan, UCB, Helsinn, Sun Pharma, Almirall, Galderma, Leo Pharma, Mylan, Celgene, Ortho Dermatology, Menlo, Merck, Qurient, Forte, Arena, Biocon, Accordant, Argenx, Sanofi, Regeneron, the National Biological Corporation, Caremark, Teladoc, BMS, Ono, Micreos, Eurofins, Informa, UpToDate, Verrica, and the National Psoriasis Foundation; he is also founder and part owner of Causa Research and holds stock in Sensal Health. Dr Claiborne reported personal fees from Sanofi, Regeneron, Arcutis, and UCB outside the submitted work. Dr Kalb reported grants from the University of Pennsylvania during the conduct of the study and grants from AbbVie, CorEvitas, Lilly, Janssen, PPD, and UCB outside the submitted work. Dr Jakus reported grants from SUNY Downstate Health Sciences University during the conduct of the study and grants from Arcutis, Dermavant, Amgen, and Incyte outside the submitted work. Dr Mangold reported personal fees from Argenyx, Boehringer Ingelheim, Bristol Myers Squibb, Lilly, Incyte, Janssen, Kyowa, Phlecs, Regeneron, Soligenix, and UCB, as well as grants from Lilly, Argenyx, Bristol Myers Squibb, Incyte, Pfizer, Regeneron, Soligenix, AbbVie, Priovant, Novartis, Palvella, and Horizon Therapeutics outside the submitted work. Dr Flowers reported other support from Acelyrin, AbbVie, Clinuvel, Sun Pharmaceutical, and Regeneron/Sanofi, as well as personal fees from Argenyx, BMS, and Janssen outside the submitted work. Dr Fretzin reported serving as a speaker and investigator for AbbVie, Amgen, Lilly, Janssen, Dermavant, and Incyte. Dr Sheehan reported grants from the National Psoriasis Foundation during the conduct of the study. Dr Krell reported support from AbbVie, Bristol Myers Squibb, UCB, Sun Pharmaceutical, Janssen Biotech, Amgen, and Lilly outside the submitted work. Dr Kaffenberger reported grants from AbbVie, Amgen, Celgene, Corrona, Lilly, Incyte, Janssen, Novartis, Pfizer, Regeneron, and UCB outside the submitted work. Dr Takeshita reported grants from Bristol Myers Squibb and Pfizer and personal fees from Incyte outside the submitted work. Dr Bridges reported personal fees from Johnson & Johnson/Janssen, Health Union, Bristol Myers Squibb, IDEOM, Wego, IGMCARE, AbbVie, the Global Healthy Living Foundation, and RVO outside the submitted work, as well as volunteering with the National Psoriasis Foundation on various projects. Dr Linn reported personal fees from JAMA Network Open and Correlation One outside the submitted work. Dr Callis Duffin reported personal fees from Amgen, AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Lilly, Janssen, Novartis, UCB, and CorEvitas, as well as grants from Boehringer Ingelheim, Pfizer, Bristol Myers Squibb, Lilly, UCB, and CorEvitas outside the submitted work. No other disclosures were reported.

References

    1. Takeshita J, Grewal S, Langan SM, et al. . Psoriasis and comorbid diseases: epidemiology. J Am Acad Dermatol. 2017;76(3):377-390. doi:10.1016/j.jaad.2016.07.064 - DOI - PMC - PubMed
    1. Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735-1741. doi:10.1001/jama.296.14.1735 - DOI - PubMed
    1. Wan MT, Shin DB, Hubbard RA, Noe MH, Mehta NN, Gelfand JM. Psoriasis and the risk of diabetes: a prospective population-based cohort study. J Am Acad Dermatol. 2018;78(2):315-322. doi:10.1016/j.jaad.2017.10.050 - DOI - PMC - PubMed
    1. Langan SM, Seminara NM, Shin DB, et al. . Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom. J Invest Dermatol. 2012;132(3 pt 1):556-562. doi:10.1038/jid.2011.365 - DOI - PMC - PubMed
    1. Patrick MT, Li Q, Wasikowski R, et al. . Shared genetic risk factors and causal association between psoriasis and coronary artery disease. Nat Commun. 2022;13(1):6565. doi:10.1038/s41467-022-34323-4 - DOI - PMC - PubMed

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