PMID- 34989291
OWN - NLM
STAT- MEDLINE
DCOM- 20220321
LR  - 20220429
IS  - 1365-2060 (Electronic)
IS  - 0785-3890 (Print)
IS  - 0785-3890 (Linking)
VI  - 54
IP  - 1
DP  - 2022 Dec
TI  - Assessment of efficacy and safety of UV-based therapy for psoriasis: a network 
      meta-analysis of randomized controlled trials.
PG  - 159-169
LID - 10.1080/07853890.2021.2022187 [doi]
AB  - BACKGROUND: Previous studies have proven that ultraviolet (UV)-based 
      phototherapy, including UVB or psoralen UVA (PUVA), and their combination 
      therapies, is effective for psoriasis treatment. OBJECTIVE: To compare the 
      clinical efficacy and adverse events (AEs) of different UV-based phototherapy in 
      psoriasis. METHODS: PubMed, Cochrane Library, Scopus and Embase were 
      systematically searched. A random-effect model network meta-analysis with 
      frequentist framework was performed, and results were reported as risk ratios 
      (RRs) with 95% CI. The main variable for assessing effectiveness and safety are 
      PASI 75 response and withdrawal due to AEs. Ranking effects were calculated by 
      surface under the cumulative ranking analysis (SUCRA). RESULTS: Thirty-two 
      studies involving a total of 2120 psoriasis patients were included in this 
      network meta-analysis. Overall, no significant difference was reported with 
      respect to withdrawal due to AEs or incidence of erythema. The relatively safest 
      strategy was combined adjuvant therapy with PUVA (cPUVA), especially PUVA 
      combined with calcium/vitamin D derivatives (RR 0.98, 95% CI [0.30-3.17], SUCRA = 
      80.8%). Both cPUVA (RR 1.39, 95% CI [1.00- 1.94]) and combined adjuvant therapy 
      with UVB (cUVB) (RR 1.27, 95% CI [1.03-1.57]) showed a superior effect than the 
      monotherapy of UVA or UVB, respectively. PUVA combined with vitamin D and its 
      derivatives (PAVD) ranked highest concerning clinical effect and safety 
      (clusterank value = 7393.2). CONCLUSIONS: The efficacy of all the combination 
      therapy regimens was significantly superior to that of UV monotherapy, without 
      significant differences in tolerability and safety. cUVB and cPUVA, and 
      particularly the combination of UVA with calcium/vitamin D derivatives, was 
      ranked as the overall safest and most effective phototherapy method.
FAU - Li, Yajia
AU  - Li Y
AD  - Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis; 
      Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Cao, Ziqin
AU  - Cao Z
AD  - Department of Spine Surgery, the Xiangya Hospital, Central South University, 
      Changsha, Hunan, China.
FAU - Guo, Jia
AU  - Guo J
AD  - Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis; 
      Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Li, Qiangxiang
AU  - Li Q
AD  - National Clinical Research Center for Geriatric Disorders of Xiangya hospital, 
      Central South University (Sub-center of Ningxia), Yinchuan, Ningxia Hui 
      Autonomous Region 750001, China.
AD  - Ningxia Geriatric Disease Clinical Research Center, People's Hospital of Ningxia 
      Hui Autonomous Region, Yinchuan, Ningxia Hui Autonomous Region 750001, China.
AD  - Hunan People's Hospital, Geriatrics Institute of Hunan Province, Changsha, China, 
      Changsha 410002, China.
FAU - Zhu, Wu
AU  - Zhu W
AD  - Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis; 
      Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, 
      Central South University, Changsha, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Kuang, Yehong
AU  - Kuang Y
AD  - Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis; 
      Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, 
      Central South University, Changsha, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Chen, Xiang
AU  - Chen X
AD  - Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis; 
      Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, 
      Central South University, Changsha, China.
AD  - National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ann Med
JT  - Annals of medicine
JID - 8906388
SB  - IM
CIN - MMW Fortschr Med. 2022 Mar;164(5):10. PMID: 35274237
MH  - Humans
MH  - Network Meta-Analysis
MH  - *Psoriasis/drug therapy/radiotherapy
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
MH  - *Ultraviolet Therapy/adverse effects/methods
PMC - PMC8741237
OTO - NOTNLM
OT  - *Psoriasis; phototherapy; UV-based therapy; network meta-analysis
COIS- The authors declare that they have no competing interests.
EDAT- 2022/01/07 06:00
MHDA- 2022/03/22 06:00
PMCR- 2022/01/06
CRDT- 2022/01/06 08:41
PHST- 2022/01/06 08:41 [entrez]
PHST- 2022/01/07 06:00 [pubmed]
PHST- 2022/03/22 06:00 [medline]
PHST- 2022/01/06 00:00 [pmc-release]
AID - 2022187 [pii]
AID - 10.1080/07853890.2021.2022187 [doi]
PST - ppublish
SO  - Ann Med. 2022 Dec;54(1):159-169. doi: 10.1080/07853890.2021.2022187.