A research team at the University of Pennsylvania will receive $8.6 million in funding to study the effectiveness of home-based phototherapy treatments for psoriasis compared to treatments that require a visit to a doctor’s office three times a week.
The Patient-Centered Outcomes Research Institute (PCORI) awarded the funding to Joel M. Gelfand, MD MSCE, a professor of Dermatology and Epidemiology in the Perelman School of Medicine at Penn, who will lead the project.
Psoriasis is a common, chronic autoimmune disease affecting more than eight million Americans with painful, thick, red patches on the skin that often itch and bleed. It also has profound effects on health-related quality of life, and in moderate to severe cases, it carries an increased risk of heart attack, stroke, and premature death. African Americans are more likely to experience severe psoriasis compared to whites, but also are less likely to receive effective treatments.
Ultraviolet B phototherapy is a preferred treatment, because systemic medications can have serious side effects. This type of phototherapy involves exposing the skin to ultraviolet light on a regular basis so Ultraviolet B rays penetrate the skin and slowing the growth of affected skin cells. The process requires treatment in an office three times per week for 12 weeks, which is a substantial burden for patients, as it pulls time away from work and family obligations and adds to transportation costs.
“Home-based phototherapy represents a more patient-centered approach, but there is a lack of data comparing its effectiveness to that of the office-based treatments,” Gelfand said. “This has led to decisional uncertainty from patients, dermatologists, and insurers.”
Gelfand’s team will conduct a randomized, controlled study in 1,050 patients age six and older to compare the effectiveness and safety of 12 weeks of home-based versus office-based phototherapy. The study will include 20 to 40 sites across the country. It will also evaluate 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 UV light penetration.
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other healthcare stakeholders in a major study conducted in real-world settings, but also for its potential to answer an important question about phototherapy and psoriasis and fill a crucial evidence gap,” said PCORI Executive Director Joe Selby, MD, MPH. “We look forward to following the study’s progress and working with Penn to share its results.”
Gelfand’s study was selected for funding through PCORI’s Pragmatic Clinical Studies Initiative, an effort to produce results that are broadly applicable to a diverse range of patients and care situations and can be more quickly taken up in routine clinical practice.