Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.
Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.
Photodermatol Photoimmunol Photomed. 2022 May;38(3):233-240. doi: 10.1111/phpp.12741. Epub 2021 Oct 25.
Phototherapies could represent an efficient option for the treatment of atopic dermatitis (AD), but the evidences available for clinical choices were contradictory.
This study aimed to evaluate the efficacy of different phototherapies on AD.
This systematic review and network meta-analysis included randomized controlled trials (RCTs) through searching keywords from PubMed, EMBASE, and the Cochrane library. We summarized different phototherapy types and scoring systems. Scoring Atopic Dermatitis (SCORAD) absolute score changes were estimated by mean differences (MDs) and standard deviations (SDs) and then included in the network meta-analysis. The effect sizes of comparison of different phototherapies were presented as MDs and 95% confidence intervals (CIs). Egger's test was used to evaluate publication bias.
Eleven RCTs were included in the systematic review and 4 studies in the network meta-analysis. Based on the pooled estimates, medium-dose ultraviolet A1 (UVA1) cold light was superior to medium-dose UVA1 (MD 8.92; 95% CI: 5.60-12.24) but no significant difference between high-dose (UVA1) and medium-dose UVA1 cold light (MD 0.66; 95% CI: -5.57 to 6.90). Publication bias was not supported by Egger's test (P = .168).
Due to possible long-term adverse effects of high-dose UVA1, medium-dose UVA1 cold light appears to be the superior form for AD.
光疗法可能是治疗特应性皮炎（AD）的有效选择，但可供临床选择的证据存在矛盾。
本研究旨在评估不同光疗方法治疗 AD 的疗效。
本系统评价和网络荟萃分析通过在 PubMed、EMBASE 和 Cochrane 图书馆中搜索关键词纳入随机对照试验（RCT）。我们总结了不同光疗类型和评分系统。通过均数差（MD）和标准差（SD）估计评分特应性皮炎（SCORAD）绝对评分变化，并将其纳入网络荟萃分析。不同光疗方法比较的效应大小以 MD 和 95%置信区间（CI）表示。采用 Egger 检验评估发表偏倚。
系统评价纳入 11 项 RCT，网络荟萃分析纳入 4 项研究。根据汇总估计值，中剂量紫外线 A1（UVA1）冷光优于中剂量 UVA1（MD 8.92；95%CI：5.60-12.24），但高剂量（UVA1）与中剂量 UVA1 冷光之间无显著差异（MD 0.66；95%CI：-5.57 至 6.90）。Egger 检验不支持发表偏倚（P =.168）。
由于高剂量 UVA1 可能存在长期不良反应，中剂量 UVA1 冷光似乎是 AD 的更佳选择。
