High-dose UVA-1 therapy improves patient-reported outcomes and clinical scores in patients with sclerosing skin disease

Summary: Abstract Body: Sclerosing disease is challenging to treat, and UVA-1 has been proposed as a potential treatment option, but little data exists. Similarly, clinical changes in sclerosing disease are difficult to assess, and patient-reported outcomes (PROs) can provide key supplementary insight on quality of life, symptoms, and functional changes. To evaluate the impact of UVA1 on sclerotic disease, we conducted a prospective, single-center, open-label clinical trial. Twenty-one patients with morphea (n=11) or systemic sclerosis (SSc) with cutaneous involvement (n=10) were given 30 treatments of high-dose UVA-1 therapy. PROs measured included Skindex-16, the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Patient Reported Outcome Measurement Information System-Physical Functioning (PROMIS-PF) score. Clinical measurements included the modified Rodnan Skin Score (mRSS), the Localized Scleroderma Assessment Tool (LoSCAT) score, the Physicians Global Assessment (PGA), and the Hand Mobility in Scleroderma (HAMIS) score. Outcomes were gathered at baseline and after 30 treatments. Linear mixed models regression was used to model change in PRO and clinical scores over time (baseline to 30 treatment). Nearly all PROs showed improvement after treatment. Skindex-16 demonstrated improvement in the emotional, symptomatic, and functioning domains (β=-16.4 (95% CI: -29.8, -3.07), β=-17.7 (-31.5, -3.92), and β=-11.4 (-21.7, -1.07) respectively). PROMIS-PF scores also demonstrated a small improvement (β=2.34, 0.01, 4.67). In parallel, objective assessments such as the mRSS (β=-6.56, -12.2, -0.90) LoSCAT Activity Index (β=-12.3, -19.0, -5.57), PGA Activity scores (β=-41.4, -55.1, -27.7), and HAMIS scores (β=-2.96, -4.35, -1.58) showed similar improvement. This data supports the efficacy of high-dose UVA-1 therapy in treating localized and systemic scleroderma, but future randomized prospective trials are needed to support this practice further. Christiaan Noot¹, Zachary Hopkins¹, Rachel Seifert², Laurel Gray², Vikram Sahni², Amber Jimenez², Christopher Hansen¹ 1. Dermatology, University of Utah Health, Salt Lake City, UT, United States. 2. School of Medicine, University of Utah Health, Salt Lake City, UT, United States. Clinical Research: Interventional Research