SAFETY AND EFFECTIVENESS OF NARROWBAND ULTRAVIOLET B PHOTOTHERAPY AS AN ADJUNCTIVE TREATMENT FOR CHRONIC SPONTANEOUS URTICARIA: A SYSTEMATIC REVIEW
Author(s)
Jahye Jung, MPH, Youjin Jung, PhD, Mihye Jeon, PhD, Min-Jeong Kim, PhD.
National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea, Republic of.
National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea, Republic of.
OBJECTIVES: Narrowband ultraviolet B (NB-UVB) phototherapy may be used as adjunctive treatment for chronic spontaneous urticaria (CSU) refractory to conventional pharmacotherapy, particularly when systemic immunomodulatory therapy is unsuitable. This systematic review assessed the clinical safety and effectiveness of NB-UVB phototherapy in CSU.
METHODS: We searched Ovid-MEDLINE, Ovid-EMBASE, EBM Reviews-Cochrane Central Register of Controlled Trials, KoreaMed, and RISS through June 18, 2025. Eligible studies assessed NB-UVB, alone or with antihistamines, versus pharmacotherapy, psoralen plus ultraviolet A (PUVA), or baseline. Outcomes were adverse events, UAS7, symptom scores, VAS, and quality of life. Two reviewers independently selected studies and extracted data. Risk of bias was assessed using Cochrane RoB and RoBANS 2.0; certainty was assessed using GRADE. Findings were synthesized qualitatively.
RESULTS: Five studies involving 257 patients were included: four randomized controlled trials and one before-after study. NB-UVB was associated mainly with mild local skin reactions; no serious adverse events or treatment discontinuations were reported. In two trials, add-on NB-UVB produced greater UAS7 reductions than antihistamines alone at treatment completion (29.45±10.57 vs 14.71±5.81; 16.78±7.91 vs 12.76±6.47), with benefits sustained at follow-up. VAS also improved more with add-on NB-UVB and remained lower 3 months after treatment. Compared with PUVA, NB-UVB showed statistically lower aUAS7 at 90 and 180 days, although clinical differences were small. One before-after study reported complete clearance in 45% and significant improvements in VAS and quality of life. Overall certainty was very low due to risk of bias and imprecision.
CONCLUSIONS: NB-UVB phototherapy was associated with only mild local adverse reactions and showed consistent signals of symptom improvement as an adjunctive option in pharmacotherapy-refractory CSU. Given the very low certainty of evidence, NB-UVB may be considered selectively when systemic immunomodulatory therapy is unsuitable. Adequately powered comparative trials are needed to strengthen the evidence base.
METHODS: We searched Ovid-MEDLINE, Ovid-EMBASE, EBM Reviews-Cochrane Central Register of Controlled Trials, KoreaMed, and RISS through June 18, 2025. Eligible studies assessed NB-UVB, alone or with antihistamines, versus pharmacotherapy, psoralen plus ultraviolet A (PUVA), or baseline. Outcomes were adverse events, UAS7, symptom scores, VAS, and quality of life. Two reviewers independently selected studies and extracted data. Risk of bias was assessed using Cochrane RoB and RoBANS 2.0; certainty was assessed using GRADE. Findings were synthesized qualitatively.
RESULTS: Five studies involving 257 patients were included: four randomized controlled trials and one before-after study. NB-UVB was associated mainly with mild local skin reactions; no serious adverse events or treatment discontinuations were reported. In two trials, add-on NB-UVB produced greater UAS7 reductions than antihistamines alone at treatment completion (29.45±10.57 vs 14.71±5.81; 16.78±7.91 vs 12.76±6.47), with benefits sustained at follow-up. VAS also improved more with add-on NB-UVB and remained lower 3 months after treatment. Compared with PUVA, NB-UVB showed statistically lower aUAS7 at 90 and 180 days, although clinical differences were small. One before-after study reported complete clearance in 45% and significant improvements in VAS and quality of life. Overall certainty was very low due to risk of bias and imprecision.
CONCLUSIONS: NB-UVB phototherapy was associated with only mild local adverse reactions and showed consistent signals of symptom improvement as an adjunctive option in pharmacotherapy-refractory CSU. Given the very low certainty of evidence, NB-UVB may be considered selectively when systemic immunomodulatory therapy is unsuitable. Adequately powered comparative trials are needed to strengthen the evidence base.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA285
Topic
Clinical Outcomes, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)