Eric Fielding credits phototherapy for turning his psoriasis from “terrible” to “almost nothing.” Fielding, 55, of Herndon, Virginia, is the husband of Maria and the proud father of a 2-month-old son, Thomas. He began phototherapy in 2014 at the suggestion of his previous dermatologist (who did not offer this treatment).
“Light therapy is great if you have access to a doctor who can provide it,” Fielding says. “My drive was 10-plus miles each way, three times a week.” That’s in the Washington, D.C., area, where a 10-mile drive can take an hour.
Before Fielding started light therapy, he had been treating only with topicals, and his body was “covered.” But the dermatologist’s light box had him almost completely cleared within three or four months. “The days of a drawer full of 20 different tubes of cortisone creams were over,” he says. “Ever since, my light therapy has just been maintenance.”
Phototherapy imrpoved the quality of life for Eric Fielding, who holds his newborn, Thomas.
After a few months of battling traffic, Fielding arranged with his insurer to do his treatments at home. He got his own narrowband ultraviolet B, three-wing light box in May 2015. Now his phototherapy sessions – two or three times a week, for 10 minutes each time – are a snap. “If I’m watching TV, my wife might remind me to do my light therapy. I’ll be back in just a few minutes,” he says.
Home-based versus office-based phototherapy: the ultimate trial
In 2017, the Patient-Centered Outcomes Research Institute awarded an $8.6 million contract to Joel Gelfand, M.D., a board-certified dermatologist whose clinical work focuses on general dermatology and psoriasis, for a clinical trial called LITE. The purpose of LITE is to study the effectiveness and safety of 12 weeks of home-based versus office-based phototherapy for the treatment of psoriasis.
LITE will involve a controlled study of approximately 1,000 patients age 12 and older under real-world conditions – either at home or at their health care provider’s office. The project started this year and is scheduled to end in 2023. LITE could someday provide the data necessary to better inform treatment decisions for hundreds of thousands of phototherapy candidates.
Gelfand and his team also will study whether patients with fairer skin are more prone to problems with tolerability, such as burns from increased light penetration, and whether those with darker skin are more prone to problems with effectiveness due to decreased ultraviolet light penetration.
The LITE study is being conducted collaboratively by the National Psoriasis Foundation and dermatologists at the University of Pennsylvania and the University of Utah.
Do you want to make psoriasis treatments more patient-centered for people like Eric Fielding? If you offer narrowband UVB phototherapy, we invite you to join us. LITE is a real-world study that reflects challenges seen in clinical practices like yours. Patients randomized to home treatment will receive home phototherapy units.
PCORI was established by the 2010 Patient Protection and Affordable Care Act. It is a 501(c)(1) organization. Funding from PCORI comes solely from the federal government.
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