Light therapy and systemic treatment for psoriasis
The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has evaluated the effect of light therapy and systemic drug treatment for moderate and severe psoriasis. The systemic drugs can be divided into two groups: synthetic and biological. SBU has also evaluated the cost of the treatments, except for the biological drugs, because the price for those is currently uncertain.
The highlights of the evaluation:
• There are no well-established studies that show the effectiveness of light therapy.
• More studies are needed to evaluate the efficacy and safety of different treatment modalities among children with moderate and severe psoriasis.
• The total cost of treatment per patient per year significantly differs between light therapy and synthetic drugs. The cheapest treatment modality is methotrexate in tablet form that has a cost of 11,000 Swedish crowns per year in total.
Sixty-five RCTs have been included to SBU´s overview, from that only one studied the effect of light therapies, while 17 assessed the synthetic, and 47 the biological drugs. There is a lack of well-established studies to assess the effectiveness of light therapies, such as UVB, PUVA and re-UVB. The majority of the studies compare the different treatment modalities with placebo. The lack of direct comparison between different modalities, makes it difficult to evaluate which treatment option performs better compared to the others. Also, there is a need for long-term follow-up studies that better corresponds to the length of treatment in real practice. Moreover, quality of life studies are needed for better health economic evaluations.
The whole report is on the website of SBU in Swedish.