A randomised, controlled clinical trial of narrowband UVB phototherapy for clinically isolated syndrome: The PhoCIS study

Prue H Hart; Anderson P Jones; Stephanie Trend; Lilian Cha; Marzena J Fabis-Pedrini; Matthew N Cooper; Catherine d'Este; Sian Geldenhuys; William M Carroll; Scott N Byrne; David R Booth; Judith M Cole; Robyn M Lucas; Allan G Kermode

doi:10.1177/2055217318773112

A randomised, controlled clinical trial of narrowband UVB phototherapy for clinically isolated syndrome: The PhoCIS study

Mult Scler J Exp Transl Clin. 2018 Apr 27;4(2):2055217318773112. doi: 10.1177/2055217318773112. eCollection 2018 Apr-Jun.

Authors

Affiliations

¹ Telethon Kids Institute, University of Western Australia, Australia.
² Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Sir Charles Gairdner Hospital, Australia.
³ National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australia.
⁴ University of Sydney, Sydney Medical School, Westmead Institute for Medical Research, Australia.
⁵ St John of God Dermatology, Australia.
⁶ Institute for Immunology and Infectious Disease, Murdoch University, Australia.

Abstract

Background: The natural history of multiple sclerosis (MS) typically presents with the clinically isolated syndrome (CIS), an episode of neurological symptoms caused by central nervous system inflammation or demyelination that does not fulfil the diagnostic criteria for MS.

Objective: As preclinical studies have suggested that exposure to ultraviolet radiation (UVR) could regulate the development of MS, the Phototherapy for CIS (PhoCIS trial) was established to examine the effects of narrowband UVB phototherapy on patients with CIS, and their conversion to MS.

Methods: Of the 20 participants, half received 24 sessions of narrowband UVB exposure over eight weeks; participants in both arms were followed for 12 months. All participants were supplemented to 25-hydroxyvitamin D₃ levels of >80 nmol/l.

Results: By 12 months, 100% of those in the no phototherapy arm and 70% in the phototherapy arm had converted to MS, although this difference was not statistically significant.

Conclusion: This study provides a basis for further studies to determine if there are any benefits of the therapeutic effects of narrowband UVB radiation on MS progression.

Keywords: Narrowband UVB phototherapy; UV-induced immunosuppression; clinically isolated syndrome; trial; vitamin D supplementation.