LITE
Trial question
Is home-based NB-UVB phototherapy noninferior to office-based NB-UVB phototherapy in patients with psoriasis?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
48.0% female
52.0% male
N = 783
783 patients (376 female, 407 male).
Inclusion criteria: adult and pediatric (aged ≥ 12 years) patients with plaque or guttate psoriasis.
Key exclusion criteria: previously unresponsive to phototherapy who received phototherapy in the past 14 days; medically unsuitable for phototherapy; psoriasis predominantly located on the scalp, body folds, genitals, palms, and/or soles or with a Physician Global Assessment average score of ≤ 1.0.
Interventions
N=393 home phototherapy (home-based NB-UVB phototherapy 2-3 times per week for 12 weeks).
N=390 office phototherapy (routine office-based NB-UVB phototherapy 2-3 times per week for 12 weeks).
Primary outcome
Physician Global Assessment score of ≤ 1 at week 12
32.8%
25.6%
32.8 %
24.6 %
16.4 %
8.2 %
0.0 %
Home
phototherapy
Office
phototherapy
Difference not exceeding
non-inferiority
margin ✓
Difference not exceeding non-inferiority margin in Physician Global Assessment score of ≤ 1 at week 12 (32.8% vs. 25.6%; AD 7.2%, 95% CI 0.8 to 13.5).
Secondary outcomes
Significant increase in Dermatology Life Quality Index score ≤ 5 at week 12 (52.4% vs. 33.6%; AD 18.6%, 95% CI 11.8 to 25.3).
No significant difference in initiation of oral or biologic psoriasis treatment at week 12 (2.9% vs. 5.7%; ARD -2.6, 95% CI -5.9 to 0.7).
No significant difference in mean duration of treatment response after week 12 (77.3 days vs. 74.2 days; AD 3.1 days, 95% CI -1.4 to 7.5).
Safety outcomes
Significant difference in better treatment adherence (51.4% vs. 15.9%) and persistent erythema (5.9% vs. 1.2%).
Conclusion
In adult and pediatric (aged ≥ 12 years) patients with plaque or guttate psoriasis, home phototherapy was noninferior to office phototherapy with respect to Physician Global Assessment score of ≤ 1 at week 12.
Reference
Joel M Gelfand, April W Armstrong, Henry W Lim et al. Home- vs Office-Based Narrowband UV-B Phototherapy for Patients With Psoriasis: The LITE Randomized Clinical Trial. JAMA Dermatol. 2024 Dec 1;160(12):1320-1328.
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