Abigail Cline, MD, PhD, Emily L. Unrue, BS, Leah A. Cardwell, MD, Hossein Alinia, MD, Rechelle Tull, BS, Steven R. Feldman, MD, PhD, and, William W. Huang, MD Adrian Pona1, MD, Abigail Cline1, MD, PhD, Sree S. Kolli1, BA, Steven R. Feldman1,2,3, MD, PhD. 1 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina 2 Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina 3 Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina Demographics, Adherence, and Satisfaction of Home UV Phototherapy in Psoriasis INTRODUCTION Narrowband UVB phototherapy offers an efficacious and safe treatment option in patients with diffuse psoriasis. However, phototherapy is usually office-based, resulting in frequent travel, costly copayment, and poor treatment adherence. [1] A domestic UVB phototherapy device offers similar efficacy and safety profile to office-based phototherapy. [2,3] We present a novel handheld narrowband UVB phototherapy device to address localized plaque-type psoriasis with a primary intention of gathering insights in demographics, adherence, and patient satisfaction. MATERIALS AND METHODS In this retrospective, open-label clinical study, treatment data was collected from 36 patients (14 males and 16 females) with plaque-type psoriasis using a novel home phototherapy system. The battery-operated phototherapy device uses UVB LEDs and an optical filter to deliver NB- UVB predominately in the 300 to 320 nm range. Patients administered treatment at home using the scheduling, dosing and guidance built into the system. The phototherapy system was also used to remotely monitor patient treatments, collecting treatment records and adherence data. Dosing was based on American Academy of Dermatology NB-UVB dosing guidelines for psoriasis. Treatments were scheduled three times per week until clearance was achieved, at which time treatment frequency and dosing were reduced in accordance with the protocol. Adherence was calculated by the number of treatments/opportunities over the first 20 treatments or first 40 opportunities. Patient satisfaction was measured using a five-point Likert scale. RESULTS Patient ages ranged from 10-65, with a mean age of 41. There were no differences in adherence or satisfaction between genders or age groups. Females had more treatment spots than men (13.1 vs 20.8, respectively (p=0.03)). Patients aged 30-39 had more treatment spots (26.6) compared to patients <29 (10.5) and patients 40-49 (13.4) (p=0.005 and p=0.002, respectively). Table 1. Patient Adherence. Figure 1. Improvement in psoriasis with home phototherapy. Top pictures were taken before initiation of phototherapy and bottom pictures were after phototherapy. (A) Phototherapy alone before and after 3 weeks, adherence 100%. (B,C,D) Phototherapy and biologic treatment before and after 16 weeks, adherence 96%. Table 2. Treatment Spots and Patient Satisfaction Figure 2. In male patients, patient age negatively correlated with adherence (R=-0.683, p=0.007). CONCLUSION The smartphone connected home UVB phototherapy system offers a convenient and satisfactory treatment option for psoriasis patients. REFERENCES 1. Rajpara AN1, O'Neill JL, Nolan BV, Yentzer BA, Feldman SR. Review of home phototherapy. Dermatol Online J. 2010 Dec 15;16(12):2. 2. Koek MB, Buskens E, van Weelden H, Steegmans PH, Bruijnzeel-Koomen CA, Sigurdsson V. Home versus outpatient ultraviolet B phototherapy for mild to severe psoriasis: pragmatic multicentre randomised controlled non-inferiority trial (PLUTO study). BMJ. 2009 May.338:b1542. [PubMed: 19423623] 3. Koek MB, Sigurdsson V, van WH, et al. Cost effectiveness of home ultraviolet B phototherapy for psoriasis: economic evaluation of a randomised controlled trial (PLUTO study). BMJ 2010;340:c1490 Disclosures Dr. Feldman has received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Baxter, Boeringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Taro, Abbvie, Cosmederm, Anacor, Astellas, Janssen, Lilly, Clarify, Merck, Merz, Novartis, Regeneron, Sanofi, Novan, Parion, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. He is founder and majority owner of www.DrScore.com and founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. Group Mean Number of Treatment Spots Median Number of Treatment Spots Mean Satisfaction Median Satisfaction Sex Men 20.8 14.5 3.6 3.0 Women 13.1 11.5 3.9 4.0 Age Under 30 10.5 11.5 4.0 4.0 30-39 26.6 27.5 3.8 4.0 40-49 13.4 11.0 3.6 3.0 50 + 14.0 9.0 3.8 4.0 Overall 16.7 12.5 3.75 4.0 Group Mean rate of adherence (%) Median rate of adherence (%) Sex Men n=14 53.8% 52.0% Women n=16 60.0% 59.5% Age Under 30 n=4 64.7% 69.4% 30-39 n=8 51.4% 44.5% 40-49 n=11 67.5% 74.1% 50+ n=7 43.1% 25.0% Overall n=30 57.1% 54.9% B C A B C D