NB-UVB phototherapy is associated with a reduction in topical corticosteroid and clinical improvement in atopic dermatitis – a historical inception cohort study.

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Despite decades of use, the magnitude of efficacy of narrowband-ultraviolet B phototherapy (NB-UVB) for atopic dermatitis (AD) outwith 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 drug dispensed to provide an objective treatment outcome in a large population catchment of 420,000 over 15 years. We analysed clinical treatment outcomes, recorded multicentre and prospectively over 15 years, as well as drug dispensed in a large AD treatment cohort (n = 844).70% of AD patients received significantly less topical corticosteroids (TCS) during the 12-month window after finishing NB-UVB, compared to the 12-month window before starting (median reduction from 37.5 to 19.7 gram/month). The number of patients dispensed with oral corticosteroid and antihistamines 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 and 20.4% of patients 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.

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Authors: J Y Choi, M Owusu-Ayim, R Dawe, S Ibbotson, C Fleming, J Foerster