{"title":"Narrow Band Ultraviolet B Phototherapy Versus Oral Cyclosporine in the Treatment of Chronic Urticaria.","authors":"Nagaraja Roshini, Hitaishi Mehta, Anuradha Bishnoi, Vinod Kumar, Ashok Kumar, Davinder Parsad, Muthu Sendhil Kumaran","doi":"10.1111/phpp.70050","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cyclosporine is currently recommended as a third-line therapy for chronic spontaneous urticaria (CSU), while narrowband ultraviolet B (NB-UVB) phototherapy has shown promise.</p><p><strong>Objective: </strong>To compare the efficacy and safety of NB-UVB phototherapy versus cyclosporine in antihistamine-refractory CSU.</p><p><strong>Methods: </strong>This randomized, prospective, non-inferiority study recruited 50 patients with antihistamine-refractory CSU. Participants received either NB-UVB (thrice weekly) or cyclosporine (3 mg/kg/day) for 90 days alongside maximum-regulated doses of antihistamines, with a post-treatment follow-up of 90 days. The primary outcome was the Urticaria Activity Score over 7 days (UAS7), with secondary outcomes including Urticaria Control Test (UCT), Chronic Urticaria Quality of Life (CU-QoL), and biomarkers such as IL-6 and IL-31.</p><p><strong>Results: </strong>Both treatments significantly reduced UAS7 by Day 15. NB-UVB provided sustained symptom control post-treatment, while cyclosporine achieved rapid relief but led to rebound flares upon discontinuation. The non-inferiority test showed that NB-UVB was not significantly worse than cyclosporine for UAS7 reduction. Both therapies reduced serum IgE, with IL-6 and IL-31 significantly decreasing in the cyclosporine group.</p><p><strong>Limitations: </strong>Single-center design, short follow-up duration.</p><p><strong>Conclusions: </strong>NB-UVB phototherapy is an effective and well-tolerated alternative to cyclosporine for antihistamine-refractory CSU, offering sustained disease suppression post-treatment. Further research is needed to explore long-term outcomes and broader applicability.</p><p><strong>Trial registration: </strong>Clinical Trials Registry of India: CTRI/2022/11/047799.</p>","PeriodicalId":20123,"journal":{"name":"Photodermatology, photoimmunology & photomedicine","volume":"41 5","pages":"e70050"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Photodermatology, photoimmunology & photomedicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/phpp.70050","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Cyclosporine is currently recommended as a third-line therapy for chronic spontaneous urticaria (CSU), while narrowband ultraviolet B (NB-UVB) phototherapy has shown promise.
Objective: To compare the efficacy and safety of NB-UVB phototherapy versus cyclosporine in antihistamine-refractory CSU.
Methods: This randomized, prospective, non-inferiority study recruited 50 patients with antihistamine-refractory CSU. Participants received either NB-UVB (thrice weekly) or cyclosporine (3 mg/kg/day) for 90 days alongside maximum-regulated doses of antihistamines, with a post-treatment follow-up of 90 days. The primary outcome was the Urticaria Activity Score over 7 days (UAS7), with secondary outcomes including Urticaria Control Test (UCT), Chronic Urticaria Quality of Life (CU-QoL), and biomarkers such as IL-6 and IL-31.
Results: Both treatments significantly reduced UAS7 by Day 15. NB-UVB provided sustained symptom control post-treatment, while cyclosporine achieved rapid relief but led to rebound flares upon discontinuation. The non-inferiority test showed that NB-UVB was not significantly worse than cyclosporine for UAS7 reduction. Both therapies reduced serum IgE, with IL-6 and IL-31 significantly decreasing in the cyclosporine group.
Limitations: Single-center design, short follow-up duration.
Conclusions: NB-UVB phototherapy is an effective and well-tolerated alternative to cyclosporine for antihistamine-refractory CSU, offering sustained disease suppression post-treatment. Further research is needed to explore long-term outcomes and broader applicability.
Trial registration: Clinical Trials Registry of India: CTRI/2022/11/047799.
期刊介绍：
The journal is a forum for new information about the direct and distant effects of electromagnetic radiation (ultraviolet, visible and infrared) mediated through skin. The divisions of the editorial board reflect areas of specific interest: aging, carcinogenesis, immunology, instrumentation and optics, lasers, photodynamic therapy, photosensitivity, pigmentation and therapy. Photodermatology, Photoimmunology & Photomedicine includes original articles, reviews, communications and editorials.
Original articles may include the investigation of experimental or pathological processes in humans or animals in vivo or the investigation of radiation effects in cells or tissues in vitro. Methodology need have no limitation; rather, it should be appropriate to the question addressed.
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