LITE Study Shows Similar Efficacy Between At-Home, In-Office Psoriasis Phototherapy

At-home phototherapy is non-inferior to in-office phototherapy in the improvement of clinical and patient-reported outcomes associated with psoriasis, according to new late-breaking data presented at the American Academy of Dermatology (AAD) 2024 Annual Meeting this weekend.

Investigators from the Light Treatment Effectiveness (LITE) study, an analysis of narrowband ultraviolet B (UVB) phototherapy administered for psoriasis either at home or in a clinician’s practice, found that either practice was associated with improved Physician’s Global Assessment (PGA) and Dermatology Life Quality Index (DLQI) scores and consistent safety.

The findings, presented by Joel Gelfand, MD, MSCE, the director of the Center for Clinical Sciences in Dermatology and Psoriasis and Phototherapy Treatment Center at University of Pennsylvania Perelman School of Medicine, additionally supported at-home and in-office phototherapy for these outcomes in all skin types, as well as the utility of home phototherapy as a first line psoriasis therapy.

In an interview with HCPLive during AAD 2024, Gelfand discussed the intent of the LITE study—an exercise in care strategy analysis that could be “something that would change and shift clinical practice to be more patient-centered.”

He cited data showing that approximately 9 in 10 US counties do not have access to phototherapy administered by a dermatologist—despite it being a proven, cost-effective treatment option for diseases like psoriasis.

“We’ve made a lot of progress in medicine—and in psoriasis in particular—but the reality is that many patients still don’t get completely clear, many patients may not want pharmaceutical management because they’re worried about infections and things of that nature,” Gelfand said. “So, patients need options available to them to manage their disease. What we really need to do is solve the problem of making (dermatology) more patient-centered and solve the systems issue so dermatologists can offer this in their office when patients need it there, and patients can also receive it at home when that’s the best way for them to receive it.

Gelfand said the impetus of the LITE study was the lacking data surrounding the efficacy of at-home phototherapy for psoriasis—despite the patients’ prioritization of the treatment option. The theme of patient-centered care options is not limited to the delivery and convenience of care, however; Gelfand highlighted considerations into race and ethnicity as to whether a patient would prefer phototherapy at home or delivered by an expert.

“So we specifically designed this study to test the hypothesis that home phototherapy would result in similar benefits to office treatments—whether you had fair skin, medium complexion skin, or dark complexion skin,” he explained.

Gelfand additionally discussed the study’s relevance to trends in increased remote and telemedicine care since the COVID-19 pandemic—an event that which briefly impeded on the LITE study itself. The end result was actually streamlined processes of care, patient engagement and follow-up that patients may have even preferred over the standard practice.

“You know what’s great about doing a real world study, is that the real world throws you curveballs,” Gelfand said. “A lot of the care became telemedicine, actually. And it became hard for us to get patients in the office. And it actually made our work much more efficient, and much more patient-centric.”

References

^{Gelfand JM, Shin DB, Armstrong A, Feldman S, et al. The Light Treatment Effectiveness (LITE) Study: A pragmatical trial of home versus office-based narrow band ultraviolet B phototherapy for the treatment of psoriasis in the United States. Paper presented at: The American Academy of Dermatology (AAD) 2024 Annual Meeting. March 8 – 12, 2024. San Diego, CA.}