Rossi Mariateresa, Damiani Caterina, Arisi Mariachiara, Tomasi Cesare, Tonon Francesco, Venturini Marina, Calzavara-Pinton Piergiacomo
Dermatology Department, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy.
Department of Experimental and Applied Medicine, Azienda Socio Sanitaria Territoriale (ASST) Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy.
J Clin Med. 2023 May 5;12(9):3303. doi: 10.3390/jcm12093303.
Narrow-band (NB) UVB and UVA1 have been successfully used for the treatment of atopic dermatitis (AD) since the 1980s, but the clinical indications for their use "at the age of biologics" remain to be assessed. From 2013 to 2017, 145 patients underwent a first treatment cycle with phototherapy. They achieved a median final EASI score of 9.90 with UVA1 and 13.70 with NB-UVB. The rates of patients achieving an IGA score of 0/1 persistent for at least 6 months were 33% with UVA1 and 28% with NB-UVB, and the rates with an EASI90 improvement were 10.9% with UVA1 and 11.0% with NB-UVB. The cut-off baseline EASI values for a good probability to achieve a 0/1 IGA were 24.4 with UVA1 and 24.7 with NB-UVB. A 0/1 IGA persistent for at least 6 months was more likely to be achieved by patients with a history of flares interspersed with periods of mild or no disease. From 2018, we only enrolled patients with the above-mentioned characteristics. The number of treated patients was lower, but the final EASI score, the rate of patients achieving IGA 0/1 persistent for at least 6 months, and EASI90 were significantly higher. Medium-dose UVA1 and NB-UVB phototherapies remain useful for the treatment of AD patients with a baseline EASI score lower than 24.4 and 24.7, respectively, and a medical history of flares followed by prolonged periods of complete or near-complete remission.
自20世纪80年代以来，窄谱（NB）UVB和UVA1已成功用于治疗特应性皮炎（AD），但其在“生物制剂时代”的临床应用指征仍有待评估。2013年至2017年，145例患者接受了光疗的第一个治疗周期。他们使用UVA1治疗后的最终EASI评分中位数为9.90，使用NB-UVB治疗后的中位数为13.70。达到IGA评分为0/1且持续至少6个月的患者比例，使用UVA1治疗的为33%，使用NB-UVB治疗的为28%；EASI改善90%的比例，使用UVA1治疗的为10.9%，使用NB-UVB治疗的为11.0%。达到IGA 0/1的良好概率对应的基线EASI值，使用UVA1治疗的为24.4，使用NB-UVB治疗的为24.7。有皮疹发作史且期间有轻度或无疾病期的患者更有可能实现IGA 0/1持续至少6个月。从2018年起，我们只纳入具有上述特征的患者。治疗的患者数量减少，但最终EASI评分、达到IGA 0/1且持续至少6个月的患者比例以及EASI90均显著更高。中剂量UVA1和NB-UVB光疗分别对基线EASI评分低于24.4和24.7且有皮疹发作病史并随后有长时间完全或接近完全缓解期的AD患者仍有用。
