RCT UVB phototherapy for CIS

[jimmylegs]

• A randomised, controlled clinical trial of narrowband UVB phototherapy for clinically isolated syndrome: The PhoCIS study (2018)
  https://journals.sagepub.com/doi/pdf/10 ... 7318773112
  
  Abstract
  Background: The natural history of multiple sclerosis (MS) typically presents with the clinically isolated syndrome (CIS), an episode of neurological symptoms caused by central nervous system inflammation or demyelination that does not fulfil the diagnostic criteria for MS.
  Objective: As preclinical studies have suggested that exposure to ultraviolet radiation (UVR) could regulate the development of MS, the Phototherapy for CIS (PhoCIS trial) was established to examine the effects of narrowband UVB phototherapy on patients with CIS, and their conversion to MS.
  Methods: Of the 20 participants, half received 24 sessions of narrowband UVB exposure over eight weeks; participants in both arms were followed for 12 months. All participants were supplemented to 25-hydroxyvitamin D3 levels of >80 nmol/l.
  Results: By 12 months, 100% of those in the no phototherapy arm and 70% in the phototherapy arm had converted to MS, although this difference was not statistically significant.
  Conclusion: This study provides a basis for further studies to determine if there are any benefits of the therapeutic effects of narrowband UVB radiation on MS progression.
  
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  Narrowband UVB phototherapy intervention
  Participants randomised to the phototherapy group received phototherapy three times per week for eight weeks to their full body (face and genitals covered) under the care of the study dermatologist (JMC). For one participant, 24 exposures were delivered over 10 weeks. A Wayne Electronics, Series M. S.1 phototherapy cabinet (Pompton Plains, NJ, USA) with output between 311 and 312 nm of 0.6 mW/cm2 was used. Phototherapy was delivered according to the Dundee protocol, based on assessment of patient skin type. The starting dose was 20 mJ/cm2 (approximately 0.7 of a minimum erythemal dose for skin type II). Doses increased by 40% increments of their initial dose, which reduced to 20% increments after six exposures, and in the absence of skin erythema increased incrementally until the final visit. Skin assessment was conducted both before and after phototherapy by the study dermatologist (JMC). Narrowband UVB phototherapy is a routine therapy for patients with psoriasis.