MedWire News: Dead Sea climatotherapy (DSC) is not only highly effective for treatment of plaque psoriasis, but has the greatest effect on early- versus late-onset forms of the disease, report researchers.
"Early-onset psoriasis, in comparison to that of late-onset, is characterized by an unstable course, tends to be more extensive, exhibits higher rates of nail and joint involvement and has an increased impact on behavior and quality of life," say Marco Harari (Research Institute at the Dead Sea, Jerusalem, Israel) and colleagues.
The team state that DCS is "an effective, natural and well-accepted treatment option for plaque psoriasis," with 20 years of treatment at their center demonstrating no difference in its clinical efficacy among the many forms of the disease.
However, no data are available for the efficacy of DSC among different psoriasis age groups, particularly those with treatment-resistant, early-onset disease.
Harari and co-researchers therefore reviewed the records of 605 plaque psoriasis patients treated between 2003 and 2007.
Patients were divided according to their age at psoriasis onset, with group I including those who were aged under 40 years (n=542), and group II those who were aged 40 years and over (n=63).
All patients received a treatment protocol consisting of 28 days bathing in the Dead Sea with UVB exposure at escalating doses over a mean 4.1 weeks. All topical treatments were discontinued and there was no between-group difference in the numbers of patients using oral or intra-muscular agents.
Treatment success was defined as an improvement of 95% or greater from baseline on the Psoriasis Assessment of Severity Index (PASI 95). PASI scores on arrival were similar among patients, at 14.08 and 13.95 for groups I and II, respectively.
Overall, DSC was considered successful in an "impressive" 73% of all cases, writes the research team in the Journal of the European Academy of Dermatology and Venereology.
And, contrary to their hypothesis, Harari et al report that group I patients achieved better results than those in group II, with 74% reaching PASI 95 compared with 62% in group II.
Logistic analysis confirmed this association regarding younger age and better DSC results with each 1-year increase in age at onset reducing the odds of treatment success by 2%.
"DSC provides an effective and an 'off-label' treatment for psoriasis," write the researchers.
They conclude that their experience indicates it is a "relatively safe method" with "virtually no side effects" that can be achieved without the need for hospitalization or comorbidity contraindications. Free abstract
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