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Plaque PsoriasisNCT02098213

Evaluation of Spa Therapy in the Treatment of Plaque Psoriasis

A study testing Immediate spa treatment and Late Spa treatment in people with Plaque Psoriasis, run by Association Francaise pour la Recherche Thermale at 5 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Assessment of quality of life after Spa therapy (4 ½ months follow-up) in the treatment of plaque psoriasis: Spa versus usual care in patients with plaque psoriasis. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Plaque Psoriasis
What is being tested?
Immediate spa treatment and Late Spa treatment
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
128 participants
Where
5 sitesFrance
Study dates
Jan 2015to Dec 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Both sexes, over 18 years of age, patients with plaque psoriasis for more than one year diagnosed by a dermatologist
  • Stable treatment in the last 6 months
  • DLQI score > 10
  • patients volunteering for spa treatment within 6 weeks
  • consenting to participate to the study with informed consent form signed after appropriate information
  • Affiliation to the French social security system or equivalent

Who cannot join

  • Pregnancy, parturient or breast feeding
  • Psychiatric illness or social situation that would preclude study compliance
  • Refusal of consent
  • Refusal of spa treatment
  • Contra-indication to spa treatment
  • Phototherapy in the last 3 months
Show all 9Show fewer
  • Guttate, pustular or erythrodermic psoriasis Isolated nail psoriasis
  • Spa therapy in the past year
  • Person deprived of liberty or under legal guardianship

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

France5 sites
  • Station Thermale Avene

    Avène, Languedoc-Rousillon, 34260

  • Thermes La Roche Posay

    La Roche-Posay, Poitou-Charentes, 86270

  • Les thermes de ST-GERVAIS

    Le Fayet, Rhône-Alpe, 74190

  • Thermes de Molitg les bains

    Molitg-les-Bains, Languedoc-Roussillon, 66500

  • Etablissement thermal d'Uriage

    Uriage-les-Bains, Rhône-Alpe, 38410

Other trials in France

About this study

Official title: Evaluation of Spa Therapy in the Treatment of Plaque Psoriasis, a Randomized, Controlled, Open Multicenter Study

Assessment of quality of life after Spa therapy (4 ½ months follow-up) in the treatment of plaque psoriasis: Spa versus usual care in patients with plaque psoriasis.

Read the detailed description

Psoriasis is one of the most common skin diseases, affecting 2-3% of the general population; more than 1 million people in France.

This auto-immune erythematosquamous inflammatory dermatosis occurs on a particular genetic background and has a chronic course. Psoriasis has a history as an indication for dermatological spa treatment (water cures in the Dead Sea). As these treatments are a combination of balneotherapy and heliotherapy, many recent studies have attempted to assess the value and position the relative benefit of each therapeutic element. Over the last four decades various different phototherapy techniques have been widely used in the treatment of psoriasis. The thermal option for many psoriasis patients depends on personal choice, or their doctor's or dermatologist's recommendation. In 1994 only one third of the 16,875 spa treatments for dermatological conditions (about 5625 cures) were for psoriasis, suggesting that spa treatment is underused as a treatment for psoriasis. Nobody can challenge the therapeutic contribution of biotherapy in the treatment of anatomically destructive diseases such as rheumatoid arthritis and psoriatic arthritis, but the use of these treatments is not without risk and economic impact. There is thus a need for less intensive treatments that have little risk of serious side effects and are less expensive.

The use of spa therapy in psoriasis should be understood as complementary and not an alternative to all other treatments. The choice of treatment is guided by the patient's characteristics and pathology (concomitant diseases, extent of lesions, treatment history) and the specialty (adverse effects, cumulative dose). In psoriasis it may be necessary to use different lines of treatment because psoriasis is a lifetime disease. Side effects of systemic treatments such as biotherapy, cyclosporine, methotrexate, synthetic retinoids, and also phototherapy (PUVA and UVB) are cumulative over time. A course of spa treatment should allow a respite before resorting to other systemic therapy.

However, the spa dermatology still suffers from a lack of large-scale evaluation and especially an objective assessment using reliable methodologies that limit bias. This is the purpose of this study.

There are no randomized controlled multicenter clinical trials evaluating spa treatment for psoriasis, although an Italian non-randomized study included a few dozen patients and confirmed the clinical benefit of the treatment.

Being tested
Immediate spa treatment, Late Spa treatment
Keywords
plaque psoriasis, DLQI, VQ Dermato, PASI, PASI change, phototherapy, balneotherapy, hydrotherapy, Euroquol EQ 5d scale, Visual analogic scale, SPA treatment Scale, PSS

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Immediate spa treatmentOther

    Also called Spa treatment soon after randomisation

    soon after randomization: Spa treatment of 3 weeks. Spa treatment : that best adapted to the concerned pathology and common to all participating of spa resorts (walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massaging shower etc)

  • Late Spa treatmentOther

    Also called Spa treatment after 4,5 months visit in the study

    soon after 4,5 months visit: Spa treatment of 3 weeks. Spa treatment : that best adapted to the concerned pathology and common to all of spa resorts (walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massaging shower etc)

Study groups in NCT02098213
Study groupRoleWhat they receive
Immediate Spa treatmentActive comparatorThree week course of spa treatment soon after randomization
Receives: Other: Immediate spa treatment
Late Spa treatmentSham comparatorThree week course of spa treatment soon after 4,5 months visit
Receives: Other: Late Spa treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Dermatology Quality of Life Index (DQLI)

    proportion of patients with a score ≤ 10 at 4½ months in each arm of the study, spa treatment versus usual care.

    Measured: 4 ½ months after randomisation

Secondary outcomes (9)
  1. Specific Quality Of Life

    proportion of patients in each arm of the study (spa treatment versus usual care) for the following specific dermatology questionnaires : DLQI score ≤ 10 at 6, 9 and 12 months and VQ Dermato score > 35 at 4 1/2, 6, 9 and 12 months

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  2. Global Quality Of Life

    EuroQOL 5D questionnaire at 4 1/2, 6, 9 and 12 months

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  3. Clinical benefit of the psoriasis

    proportion of patients with a PASI (Psoriasis Area and Severity Index) 50 and PASI 75 at 4½, 6, 9 and 12 months in each arm of the study, spa treatment versus usual care.

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  4. pain and pruritus

    Self-administered questionnaire with Visual Analogue Scale for pain and for pruritus at 4 1/2, 6, 9, 12 months

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  5. Treatment follow up

    • Assessment of topical treatments within 12 months (number of tubes used per month)
    • Number of phototherapy sessions
    • Use of conventional systemic therapies (acitretin, methotrexate, cyclosporine) (number of weeks of treatment and dosage)
    • Number of weeks of treatment by biotherapy
    • Reduction in the use of the health care system (Number of hospitalizations and specialized consultations in connection with psoriasis or not) within 12 months
    • Reports on the use of complementary and alternative medicines within12 months

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  6. patient's examination

    Impact of the spa treatment on overall metabolism indicators in the year

    Will be collected at 4 1/2, 6, 9 and 12 months in the two groups:

    • height an weight (BMI calculation)
    • Waist measurement
    • Blood pressure

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  7. Safety evaluation

    Evaluation of all adverse events attributable to treatment, or not, according to the usual criteria of pharmacovigilance in clinical trials

    Measured: 4 1/2, 6, 9 and 12 months after randomisation

  8. Stress evaluation

    self administered questionnaire (PSS: Assessment of stress) at inclusion in the study only

    Measured: 4 1/2, 6, 9 and 12 months after randomisatio

  9. Long term evaluation

    Evaluation of the maintenance of benefits at 12 months (stability of the long term effect) on the primary outcome and secondary outcomes.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Mar 2014 (estimated)
  2. Study startJan 2015
  3. Primary completion15 May 2019
  4. Study completionDec 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Taking into account the hypothesis of a proportion of patients with a DLQI≤10 (absence of repercussion or low impact of psoriasis on quality of life) of 25% at 4 months 1/2 in the arm immediate spa treatment versus 10% in the usual care group (late spa treatment), 113 patients per group is required, with an alpha 5% risk and a power of 80 %. Given the risk of potential patients lost to follow-up estimates of 15%, we plan to include 130 patients per randomisation group, so 260 patients in total. According to the protocol submitted to authorities, given the uncertainties of necessary hypothesis, a re-evaluation of the number of subjects required after the first 100 inclusions is planned. This reassessment will be carried out without intermediate analysis but in view of the results observed for the primary endpoint in mean and standard deviation (event driven).
Masking
None (open label)
Enrolment
128 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02098213
Sponsor's protocol ID
PSOTHERMES
Status last verified
Jan 2020
First submitted
17 Mar 2014
Last updated
9 Jan 2020
Results posted
No
Data monitoring committee
No

Publications

  • Halverstam CP, Lebwohl M. Nonstandard and off-label therapies for psoriasis. Clin Dermatol. 2008 Sep-Oct;26(5):546-53. doi: 10.1016/j.clindermatol.2007.10.023.

    PubMed 18755374
  • Kazandjieva J, Grozdev I, Darlenski R, Tsankov N. Climatotherapy of psoriasis. Clin Dermatol. 2008 Sep-Oct;26(5):477-85. doi: 10.1016/j.clindermatol.2008.05.001.

    PubMed 18755366
  • ALT J, NONCLERCQ E. [Treatment of psoriasis by ultraviolet and photosensitizers]. Bull Soc Fr Dermatol Syphiligr. 1953 Jul-Oct;60(4):343-5. No abstract available. Undetermined Language.

    PubMed 13115903
  • Grupper C, Bourgeois-Spinasse J, Eisenmann D. [Treatment of psoriasis in 1970]. Cah Med. 1970 Sep;11:Suppl:15-20. No abstract available. French.

    PubMed 5454618
  • Oddoze L, Temime P, Marchand JP, Benne M. [Combined oral meladinine and ultraviolet rays in the treatment of psoriasis. (Preliminary note)]. Bull Soc Fr Dermatol Syphiligr. 1967;74(5):609-10. No abstract available. French.

    PubMed 5587899
  • SOLOMON WM, NETHERTON EW, NELSON PA, ZEITER WJ. Treatment of psoriasis with Goeckerman technic. Arch Phys Med Rehabil. 1955 Feb;36(2):74-7. No abstract available.

    PubMed 13229486
  • Young E. Ultraviolet therapy of psoriasis: a critical study. Br J Dermatol. 1972 Oct;87(4):379-82. doi: 10.1111/j.1365-2133.1972.tb07426.x. No abstract available.

    PubMed 4562168
  • van de Kerkhof PC. Therapeutic strategies: rotational therapy and combinations. Clin Exp Dermatol. 2001 Jun;26(4):356-61. doi: 10.1046/j.1365-2230.2001.00829.x.

    PubMed 11422189
  • Weinstein GD, White GM. An approach to the treatment of moderate to severe psoriasis with rotational therapy. J Am Acad Dermatol. 1993 Mar;28(3):454-9. doi: 10.1016/0190-9622(93)70067-4.

    PubMed 8445062
  • Lebwohl M. Combining the new biologic agents with our current psoriasis armamentarium. J Am Acad Dermatol. 2003 Aug;49(2 Suppl):S118-24. doi: 10.1016/s0190-9622(03)01144-7.

    PubMed 12894135
  • Tabolli S, Calza A, Di Pietro C, Sampogna F, Abeni D. Quality of life of psoriasis patients before and after balneo -- or balneophototherapy. Yonsei Med J. 2009 Apr 30;50(2):215-21. doi: 10.3349/ymj.2009.50.2.215.

    PubMed 19430554
  • Grob JJ, Auquier P, Martin S, Lancon C, Bonerandi JJ. Development and validation of a quality of life measurement for chronic skin disorders in french: VQ-Dermato. The ReseaudEpidemiolo gie en Dermatologie. Dermatology. 1999;199(3):213-22. doi: 10.1159/000018250.

    PubMed 10592400
  • Hsu S, Papp KA, Lebwohl MG, Bagel J, Blauvelt A, Duffin KC, Crowley J, Eichenfield LF, Feldman SR, Fiorentino DF, Gelfand JM, Gottlieb AB, Jacobsen C, Kalb RE, Kavanaugh A, Korman NJ, Krueger GG, Michelon MA, Morison W, Ritchlin CT, Stein Gold L, Stone SP, Strober BE, Van Voorhees AS, Weiss SC, Wanat K, Bebo BF Jr; National Psoriasis Foundation Medical Board. Consensus guidelines for the management of plaque psoriasis. Arch Dermatol. 2012 Jan;148(1):95-102. doi: 10.1001/archdermatol.2011.1410.

    PubMed 22250239
  • Pathirana D, Ormerod AD, Saiag P, Smith C, Spuls PI, Nast A, Barker J, Bos JD, Burmester GR, Chimenti S, Dubertret L, Eberlein B, Erdmann R, Ferguson J, Girolomoni G, Gisondi P, Giunta A, Griffiths C, Honigsmann H, Hussain M, Jobling R, Karvonen SL, Kemeny L, Kopp I, Leonardi C, Maccarone M, Menter A, Mrowietz U, Naldi L, Nijsten T, Ortonne JP, Orzechowski HD, Rantanen T, Reich K, Reytan N, Richards H, Thio HB, van de Kerkhof P, Rzany B. European S3-guidelines on the systemic treatment of psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2009 Oct;23 Suppl 2:1-70. doi: 10.1111/j.1468-3083.2009.03389.x.

    PubMed 19712190
  • Basra MK, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008 Nov;159(5):997-1035. doi: 10.1111/j.1365-2133.2008.08832.x. Epub 2008 Sep 15.

    PubMed 18795920

Questions about this trial

What is this clinical trial studying?

A study testing Immediate spa treatment and Late Spa treatment in people with Plaque Psoriasis, run by Association Francaise pour la Recherche Thermale at 5 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Dermatology Quality of Life Index (DQLI) (time frame: 4 ½ months after randomisation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02098213, which also lists 20 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jan 2020.

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