The UPDATE Trial (Uvb Phototherapy in Dermatology for ATopic Eczema)

NCT ID: NCT05704205

Last Updated: 2025-10-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

316 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-22

Study Completion Date

2026-12-31

Brief Summary

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The goal of this randomized controlled trial is to study the (cost)effectiveness of NB-UVB phototherapy in patients with atopic eczema/atopic dermatitis.

Half of the participants will undergo a course of NB-UVB phototherapy of 8-16 weeks and apply optimal topical therapy (OTT) for a minimum of 3 months. Researchers will compare the outcomes of this group with the other half of participants that apply OTT only.

Detailed Description

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Atopic eczema (AE) is a chronic fluctuating dermatological disease characterized by a pruritic inflammation of the skin. The condition poses a high global (financial) burden. One of the therapeutic options of AE is phototherapy, with narrowband UVB (NB-UVB) being the most common. The evidence of the (cost-)effectiveness of NB-UVB, however, is scarce and of low quality.

The objective of this pragmatic multicenter single blinded randomized controlled trial is comparing the effectiveness and cost-effectiveness of narrowband ultraviolet B with optimal topical therapy (NB-UVB+OTT) versus OTT at 3 months in adult patients with insufficient control of their AE with standard topical treatment, for whom dermatologist and patient jointly believe that NB-UVB or OTT is needed.

Participants that are randomized into the NB-UVB+OTT group will receive an NB-UVB course (at home or at the outpatient clinic) for at least 8 and up to 16 weeks, combined with OTT for at least 3 months. Participants in the control group (OTT group) will apply OTT for at least 3 months. Visits will occur at baseline and 1-3-6-9-12 months after start. At baseline, patient information is collected including an evaluation of medical history and a physical examination to assess Fitzpatrick skin type and physician-reported clinical signs. During each visit patients are asked to fill out questionnaires. Risks are expected to be as in daily practice.

Primary study parameters/outcome of the study is the percentage of patients with EASI50 (a decrease of the Eczema Area and Severity Index of 50%) at 3 month follow-up. Secondary study parameters/outcome of the study include delta EASI, physician-reported clinical signs, patient-reported symptoms, quality of life, long-term control, cost-effectiveness, side effects at 1-3-6-9-12 months, quantity and potency topical steroid usage, time to starting systemic therapy, patient satisfaction with received treatment, percentage of patients reaching Treatment Target goals and percentage of drop-outs with reasons at 3-6-9-12 months.

Conditions

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Atopic Dermatitis Eczema Atopic Dermatitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Single blinded

Study Groups

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NB-UVB+OTT

8-16 weeks of NB-UVB phototherapy combined with (a minimum of) 3 months of optimal topical therapy

Group Type EXPERIMENTAL

NB-UVB phototherapy

Intervention Type DEVICE

Narrowband ultraviolet B irradiation 3 times a week

Optimal topical therapy

Intervention Type COMBINATION_PRODUCT

A combination of detailed instructions about the disease and treatments by trained nurses, bathing and washing advices, adequate emollients use, avoidance of triggers (including possible and proven contact allergens), fingertip unit explanation for active topical therapy, and personalized topical therapy with different potency topical steroids, calcineurin inhibitors and tar ointments

Optimal topical therapy (OTT)

(a minimum of) 3 months of optimal topical therapy

Group Type ACTIVE_COMPARATOR

Optimal topical therapy

Intervention Type COMBINATION_PRODUCT

A combination of detailed instructions about the disease and treatments by trained nurses, bathing and washing advices, adequate emollients use, avoidance of triggers (including possible and proven contact allergens), fingertip unit explanation for active topical therapy, and personalized topical therapy with different potency topical steroids, calcineurin inhibitors and tar ointments

Interventions

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NB-UVB phototherapy

Narrowband ultraviolet B irradiation 3 times a week

Intervention Type DEVICE

Optimal topical therapy

A combination of detailed instructions about the disease and treatments by trained nurses, bathing and washing advices, adequate emollients use, avoidance of triggers (including possible and proven contact allergens), fingertip unit explanation for active topical therapy, and personalized topical therapy with different potency topical steroids, calcineurin inhibitors and tar ointments

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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Narrowband ultraviolet B phototherapy OTT Optimal local therapy

Eligibility Criteria

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Inclusion Criteria

* Adult (≥18 years of age) patient meeting the UK working party criteria for atopic eczema;
* AE insufficiently controlled by standard topical care and therefore eligible for NB-UVB or OTT;
* Investigator Global Assessment (IGA, 0-4) of ≥ 2 (moderate disease);
* Eczema Area and Severity Index (EASI) of ≥ 7 (moderate disease);
* Understood and voluntarily signed and dated an informed consent form prior to any study-related procedure or has a legal representative who has, and is willing to comply with the study's requirements.

Exclusion Criteria

* Contra-indication for NB-UVB;

* Genetic defects associated with photosensitivity or skin cancer;
* Heavily photo-damaged skin;
* History of multiple (\>1) skin malignancies;
* Use of systemic immunosuppressants/immunomodulators;
* Use of medication associated with photosensitivity;
* Patient is already on systemic AE therapy;
* Patient is already on OTT in the past 2 months;
* NB-UVB or any systemic therapy in the past 9 months.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ZonMw: The Netherlands Organisation for Health Research and Development

OTHER

Sponsor Role collaborator

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

OTHER

Sponsor Role lead

Responsible Party

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Prof. Dr. Phyllis I. Spuls

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Louise AA Gerbens, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Amsterdam University Medical Centers

Locations

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Flevoziekenhuis

Almere Stad, Flevoland, Netherlands

Site Status

Jeroen Bosch Ziekenhuis

's-Hertogenbosch, North Brabant, Netherlands

Site Status

Centrum Oosterwal

Alkmaar, North Holland, Netherlands

Site Status

OLVG

Amsterdam, North Holland, Netherlands

Site Status

Amsterdam Universitair Medische Centra

Amsterdam, North Holland, Netherlands

Site Status

Huid Medisch Centrum

Amsterdam, North Holland, Netherlands

Site Status

Bergman Clinics

Haarlem, North Holland, Netherlands

Site Status

Spaarne Gasthuis

Hoofddorp, North Holland, Netherlands

Site Status

Dijklander Ziekenhuis

Purmerend, North Holland, Netherlands

Site Status

Isala Klinieken

Zwolle, Overijssel, Netherlands

Site Status

Medisch Centrum Leeuwarden

Leeuwarden, Provincie Friesland, Netherlands

Site Status

Reinier de Graaf Gasthuis

Delft, South Holland, Netherlands

Site Status

Leids Universitair Medisch Centrum

Leiden, South Holland, Netherlands

Site Status

Alrijne Ziekenhuis

Leiderdorp, South Holland, Netherlands

Site Status

Erasmus Medisch Centrum

Rotterdam, South Holland, Netherlands

Site Status

Meander Medisch Centrum

Amersfoort, Utrecht, Netherlands

Site Status

Countries

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Netherlands

References

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Knops E, Spuls P, Duijnhoven R, Dijkgraaf M, van Barreveld M, Arents B, van Enst A, Garritsen F, Merkus M, Middelkamp-Hup MA, Musters A, Bosma A, Hyseni A, Dijkstra J, Hijnen DJ, Gerbens L. The UPDATE trial (UVB Phototherapy in Dermatology for ATopic Eczema): study protocol for a randomized controlled trial of narrowband UVB with optimal topical therapy versus optimal topical therapy in patients with atopic eczema. Trials. 2024 Jul 16;25(1):482. doi: 10.1186/s13063-024-08334-z.

Reference Type DERIVED
PMID: 39014498 (View on PubMed)

Other Identifiers

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NL81882.018.22

Identifier Type: -

Identifier Source: org_study_id

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