Atopic eczema (AE) is a chronic inflammatory skin disease manifested by itching, redness and scaling. AE is a common form of eczema and is treated with topical, photo- or systemic therapy (pills/injections). There are many types of phototherapy but nowadays narrowband (NB)-UVB is mostly used for AE. Per year, around 1700 courses of UVB therapy are used but it is not very clear how effective this treatment is for this indication. The research group of Spuls has reviewed the available evidence to date using a Cochrane systematic review, which showed that there is not enough information available to draw strong conclusions on the effectiveness of different phototherapies investigated in AE RCTs. Therefore, the reimbursement of this treatment is under debate.
With the grant that the research group will receive, a national multicenter RCT will be performed to answer part of one of the top 10 research questions of the NVDV (the Dutch Association for Dermatology and Venereology). This question concerns the effectiveness of photo- and systemic treatments in patients with AE. If NB-UVB therapy turns out to be effective it could prevent patients from starting with systemic therapy, which would be good news for the patient since systemic therapy in AE can be a burdensome treatment. If NB-UVB therapy seems to be equal or less effective compared to optimized topical therapy, then NB-UVB is not to be considered a standard step in the treatment algorithm.
As of 2017, Spuls and colleagues are already running a prospective registry in which patients with AE and their photo- or systemic treatments are followed, the so-called TREAT (TREatment of ATopic eczema) NL registry. This study is part of an international initiative: the TREAT Registry Taskforce. The team, and currently in particular Dr. Louise Gerbens, is also working on establishing national and international guidelines for the treatment of AE.
The goal of the Health Care Evaluation and Appropriate Use (ZE&GG) program is to realize appropriate use of care, with effective spending of public funds. The ultimate goal is availability of optimal medical and nursing care for all. ZonMw is a strategic partner.
Team
The lead applicant for this grant is prof. dr. Phyllis Spuls. dr. Pina Middelkamp-Hup and dr. Louise Gerbens are the project leaders. Arienna Hyseni and Jitske Dijkstra are the research nurses, and rs. Angela Bosma and drs. Annelie Musters are PhDs. Other committee members are: prof. dr. Marcel Dijkgraaf (Amsterdam UMC), dr. Ruben Duijnhoven (Amsterdam UMC), dr DJ Hijnen (Erasmus MC) , dr Floor Garritsen (HagaZiekenhuis, The Hague), Dr Annefloor van Enst (NVDV) and Bernd Arents (VMCE). Methodologist dr. Maruschka Merkus is the project advisor from the Department of Epidemiology & Datascience Amsterdam UMC.
In total, about 10 secondary care hospitals and 3 academic centers will participate in the study.
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