Department of Dermatology, University Hospital of Bordeaux, Bordeaux, France.
French Psoriasis Research Group (GrPSO) of the French Society of Dermatology, Paris, France.
Int J Biometeorol. 2022 Jun;66(6):1247-1256. doi: 10.1007/s00484-022-02273-7. Epub 2022 Mar 26.
Spa therapy is considered an add-on treatment for psoriasis, but without any objective evaluation in the absence of randomized trials. This multicenter, open-label, randomized trial compared immediate spa therapy versus a control group having usual treatments until study assessments at 4.5 months. Spa therapy was proposed in five French spa resorts with standardized programs. Inclusion criteria were adults with plaque psoriasis, Dermatology Life Quality Index (DLQI) > 10, and stable medical treatment in the last 6 months. The main objective was DLQI ≤ 10 at 4.5 months after inclusion. VQ-Dermato and EQ5D-3L also assessed quality of life (QoL), Perceived Stress Scale (PSS) stress, and visual analogue scales (VAS) pain and pruritus. Between January 2015 and November 2018, 128 patients were randomized to either immediate spa therapy (64) (within 34 days, median) or usual treatments (61) until assessment at 4.5 months. Most were first-time spa users (71.2%). Mean DLQI and Psoriasis Area and Severity Index at inclusion were 16.7 and 10.5, respectively. Immediate spa therapy patients achieved the primary objective for 66.1% [95% CI 52.6% > 77.9%] vs 41.4% [95% CI 28.6% > 55.1%] control group patients (p = 0.007). VQ-Dermato scores and pruritus VAS significantly improved. Outcomes at 12-month follow-up of the immediate spa therapy group showed persistent improvement of DLQI, VQ-Dermato, and pruritus. This randomized controlled trial demonstrated that a cure of spa therapy improves QoL and alleviates certain symptoms of psoriasis, in short and long terms. This justifies its integration in the therapeutic strategies for psoriasis. Trial registration number: ClinicalTrials.gov Identifier: NCT02098213.
水疗被认为是银屑病的附加治疗方法，但由于缺乏随机试验，没有任何客观评估。本多中心、开放性、随机试验比较了即刻水疗与对照组（在研究评估时接受常规治疗直至 4.5 个月）。水疗在法国五个水疗胜地进行，采用标准化方案。纳入标准为斑块状银屑病成人、皮肤病生活质量指数（DLQI）>10 且过去 6 个月内稳定的药物治疗。主要目标是在纳入后 4.5 个月时 DLQI≤10。VQ-Dermato 和 EQ5D-3L 还评估了生活质量（QoL）、感知压力量表（PSS）压力以及视觉模拟量表（VAS）疼痛和瘙痒。2015 年 1 月至 2018 年 11 月，128 例患者被随机分为即刻水疗组（64 例）（中位时间为 34 天）或对照组（61 例），直至 4.5 个月评估。大多数患者为首次使用水疗（71.2%）。纳入时的平均 DLQI 和银屑病面积和严重程度指数（PASI）分别为 16.7 和 10.5。即刻水疗组 66.1%（95%CI 52.6%77.9%）达到主要终点，而对照组为 41.4%（95%CI 28.6%55.1%）（p=0.007）。VQ-Dermato 评分和瘙痒 VAS 显著改善。即刻水疗组的 12 个月随访结果显示，DLQI、VQ-Dermato 和瘙痒持续改善。这项随机对照试验表明，水疗的治愈可以改善 QoL，并在短期和长期内缓解银屑病的某些症状。这证明了其整合到银屑病的治疗策略中的合理性。试验注册编号：ClinicalTrials.gov 标识符：NCT02098213。
