UVB phototherapy in an outpatient setting or at home: a pragmatic randomised single-blind trial designed to settle the discussion. The PLUTO studyReportar como inadecuado




UVB phototherapy in an outpatient setting or at home: a pragmatic randomised single-blind trial designed to settle the discussion. The PLUTO study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Medical Research Methodology

, 6:39

First Online: 01 August 2006Received: 04 July 2006Accepted: 01 August 2006

Abstract

BackgroundHome ultraviolet B UVB treatment is a much-debated treatment, especially with regard to effectiveness, safety and side effects. However, it is increasingly being prescribed, especially in the Netherlands. Despite ongoing discussions, no randomised research has been performed, and only two studies actually compare two groups of patients. Thus, firm evidence to support or discourage the use of home UVB phototherapy has not yet been obtained. This is the goal of the present study, the PLUTO study Dutch acronym for -national trial on home UVB phototherapy for psoriasis-.

MethodsWe designed a pragmatic randomised single-blind multi-centre trial. This trial is designed to evaluate the impact of home UVB treatment versus UVB phototherapy in a hospital outpatient clinic as to effectiveness, quality of life and cost-effectiveness. In total 196 patients with psoriasis who were clinically eligible for UVB phototherapy were included. Normally 85% of the patients treated with UVB show a relevant clinical response. With a power of 80% and a 0.05 significance level it will be possible to detect a reduction in effectiveness of 15%. Effectiveness will be determined by calculating differences in the Psoriasis Area and Severity Index PASI and the Self Administered PASI SAPASI scores. Quality of life is measured using several validated generic questionnaires and a disease-specific questionnaire. Other outcome measures include costs, side effects, dosimetry, concomitant use of medication and patient satisfaction. Patients are followed throughout the therapy and for 12 months thereafter. The study is no longer recruiting patients, and is expected to report in 2006.

DiscussionIn the field of home UVB phototherapy this trial is the first randomised parallel group study. As such, this trial addresses the weaknesses encountered in previous studies. The pragmatic design ensures that the results can be well generalised to the target population. Because, in addition to effectiveness, aspects such as quality of life and cost-effectiveness are also taken into consideration, this study will produce valuable evidence to either support or discourage prescription of home UVB phototherapy.

Trial registrationCurrent controlled trials-Nederlands Trial register: ISRCTN83025173. Clinicaltrials.gov: NCT00150930

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2288-6-39 contains supplementary material, which is available to authorized users.

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Autor: Mayke BG Koek - Erik Buskens - Paul HA Steegmans - Huib van Weelden - Carla AFM Bruijnzeel-Koomen - Vigfús Sigurdsson

Fuente: https://link.springer.com/







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