Polderman M C, Huizinga T W, Le Cessie S, Pavel S
Department of Dermatology, Leiden University Medical Centre, The Netherlands.
Ann Rheum Dis. 2001 Feb;60(2):112-5. doi: 10.1136/ard.60.2.112.
Treatment of patients with systemic lupus erythematosus (SLE) often implies strong drugs with possibly serious side effects. Thus there is a need for new immunosuppressive treatments. Long wave ultraviolet A (UVA-1) cold light therapy is an anti-inflammatory, immunomodulatory treatment with a possible systemic effect and few side effects. In the current study low dose UVA-1 cold light treatment was tested to determine whether it reduces disease activity in SLE.
Eleven patients with SLE were treated with UVA-1 cold light treatment and a placebo light treatment in a double blind, placebo controlled, crossover study. In two consecutive 12 week periods the patients were treated in the first three weeks with UVA-1 and placebo treatment or vice versa. The primary variables were the SLE Disease Activity Index (SLEDAI) and SLE Activity Measure (SLAM).
The mean SLAM and SLEDAI showed a significant decrease of 30.4% (p=0.0005) and 37.9% (p=0.016) respectively after three weeks of UVA-1 and a non-significant decline of 9.3% (p=0.43) and 12.2% (p=0.54) respectively after three weeks of placebo treatment. In this small trial the difference in reduction of the disease activity indices during UVA-1 compared with during placebo treatment failed to reach the conventional border of significance (p=0.07). The total score of quality of life measure RAND-36 did not improve significantly, but the subscore for vitality did improve.
Low dose UVA-1 cold light treatment was strongly suggestive of lowering disease activity in this double blind placebo controlled study, and no side effects occurred.
系统性红斑狼疮(SLE)患者的治疗通常需要使用强效药物,而这些药物可能会带来严重的副作用。因此,需要新的免疫抑制治疗方法。长波紫外线A(UVA-1)冷光疗法是一种具有抗炎、免疫调节作用的治疗方法,可能具有全身效应且副作用较少。在本研究中,对低剂量UVA-1冷光治疗进行了测试,以确定其是否能降低SLE的疾病活动度。
在一项双盲、安慰剂对照、交叉研究中,11例SLE患者接受了UVA-1冷光治疗和安慰剂光治疗。在连续两个12周的周期内,患者在前三周接受UVA-1治疗和安慰剂治疗,或反之。主要变量为SLE疾病活动指数(SLEDAI)和SLE活动度量表(SLAM)。
UVA-1治疗三周后,平均SLAM和SLEDAI分别显著下降了30.4%(p=0.0005)和37.9%(p=0.016),而安慰剂治疗三周后分别非显著下降了9.3%(p=0.43)和12.2%(p=0.54)。在这项小型试验中,与安慰剂治疗期间相比,UVA-1治疗期间疾病活动指数降低的差异未达到传统的显著性界限(p=0.07)。生活质量测量量表RAND-36的总分没有显著改善,但活力子分数有所改善。
在这项双盲安慰剂对照研究中,低剂量UVA-1冷光治疗强烈提示可降低疾病活动度,且未出现副作用。