A pragmatic randomized controlled trial on the effectiveness of highly concentrated saline spa water baths followed by UVB compared to UVB only in moderate to severe psoriasis.

Authors: Brockow T (1,2) , Schiener R (3,4) , Franke A (2,5,6) , Resch KL (1,2) , Peter RU (3,7)

Affiliations:

(1) FBK German Institute for Health Research (2) FBK Spa Medicine Research Institute, Bad Elster (3) Department of Dermatology, University of Ulm (4) Dermatologic Outpatient Clinic, Würzburg (5) Coordination Centre of Clinical Trials Leipzig, University of Leipzig (6) Center of Biomedical Statistics, Bad Elster (7) Hospital and Clinic for Vascular Surgery and Dermatology, Ulm-Blaustein

Source: J Altern Complement Med. 2007 Sep;13(7):725-32.

Language: English Countries: Not specified Location: Not specified Correspondence address: Brockow T : thomas.brockow@d-i-g.org

Keywords

Article abstract

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.

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