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Daylight photodynamic therapy a less painful alternative for actinic keratoses

25 Jan 2019

Daylight photodynamic therapy (DLPDT) represents a promising treatment option for actinic keratoses (AKs), with the results of a meta-analysis showing that while comparable to conventional PDT (CPDT) in terms of efficacy, DLPDT is associated with less pain and high patient satisfaction.

Researchers searched multiple online databases for randomized controlled trials evaluating the safety and efficacy of DLPDT vs CPDT in adult patients with AKs presenting on the face or scalp. Outcome measures were complete response rate, patient satisfaction and patient‐reported pain.

The meta-analysis included eight trials comprising a total of 424 patients, all of whom were aged >60 years and the majority being male. Pooled data revealed no significant differences in the lesion response rate (relative risk [RR], 0.892; 95 percent CI, 0.818–0.973; p=0.01; I2, 69.80 percent) and the mean lesion response (standardized mean difference [SMD], –0.221; –0.395 to –0.027; p=0.024; I2, 29.20 percent) between DLPDT and CPDT.

However, DLPDT was associated with higher patient satisfaction (RR, 4.001; 2.017–7.938; p<0.001; I2, 82.40 percent) and lower level of pain (SMD, –2.544; –3.57 to –1.632; p<0.001; I2, 94.90 percent).

Sensitivity analyses showed that the results were of high stability and low sensitivity. Meanwhile, Begg’s and Egger’s tests indicated no significant publication bias among studies under all comparisons.

Overall, the findings demonstrate the potential of DLPDT to become a novel treatment option for AKs, particularly in patients who cannot tolerate intense pain, according to researchers. The data could also factor in selecting the most appropriate therapeutic method for treating AKs and in guiding physicians to optimize treatment strategies.

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