A pragmatic randomized controlled trial on the effectiveness of low concentrated saline spa water baths followed by ultraviolet B (UVB) compared to UVB only in moderate to severe psoriasis

Abstract

In routine clinical practice balneophototherapy using conventional UVB is superior to conventional UVB only at the end of a 6-week treatment course.

The Impact of Salt Water Soaks on Biophysical and Molecular Parameters in Psoriatic Epidermis Equivalents

“…The first study, involving 1,241 patients, convincingly demonstrated that bathing in salt water before UVB exposure is superior to UVB monotherapy as well as to tap water baths before UVB exposure [7]. The results of the second trial, involving 143 patients, indicated that BPT using low-concentration saline spa water baths followed by conventional UVB phototherapy was superior to conventional UVB monophototherapy at the end of a 6-week treatment course [8]. The same study group showed in another trial that psoriasis patients allocated to highly concentrated saline spa water baths plus UVB phototherapy for 6 weeks achieved a statistically significantly higher rate of PASI-50 than patients allocated to UVB only [9].…”

Incomplete Data in Randomized Dermatology Trials: Consequences and Statistical Methodology

“…a PASI 75 score of yes or no). It is particularly concerning when a large portion of responses are missing, or when dropout rates are considerably higher in one treatment group than another [44]. …”

“…This use of intermediary responses can, therefore, be much more attractive than the generally invalid LOCF approach often employed in practice. Comparisons based on repeated measurements may alternatively be carried out based on the mean responses at each time point via marginal models and generalized estimating equations [44], in which case multiple imputation or IPW approaches may be used to achieve valid estimates when responses are MAR.…”

S3‐Leitlinie zur Therapie der Psoriasis vulgaris Update 2011

“…Für diese Modalität wurden Studien mit Behandlungsfrequenzen von zwei [181], drei [182][183][184][185][186], fünf [187,188] [191], zweimal [192][193][194], dreimal [147,184,195,196] oder 4 x/Wo [193,197] In mehreren kleinen [195,[199][200][201] sowie einer größeren nichtrandomisierten Studie [202] [197,212] treten jedoch mit ca. 5 % eher selten auf [197].…”