Lasers may improve the efficacy of photodynamic therapy (PDT) in the treatment of actinic keratoses, according to the findings of a recent study.
PDT is known to be an effective intervention for actinic keratoses, as well as field cancerization. “Ablative fractional lasers may facilitate the delivery of photosensitizers and thereby improve the effects of PDT,” the researchers hypothesized. They performed a systematic literature review and identified randomized controlled trials that assessed the safety and efficacy of laser-assisted PDT. The risk of bias was estimated with the Cochrane Risk of Bias Tool, and the quality of evidence of the outcomes was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.
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Among 817 trials identified by the researchers, 7 were included in the qualitative analysis and 4 were included in the meta-analysis.
The researchers found laser-assisted PDT showed significantly higher clearance rates compared with PDT monotherapy (risk ratio 1.33; 95% CI 1.24-1.42). However, the studies had a high risk of bias, the researchers said, adding that a limitation of their review was clinical heterogeneity of the included studies. In addition, “there was no difference in pain intensity between laser-assisted PDT and other interventions,” they added.
“Laser-assisted PDT is more efficient but not more painful than PDT or laser treatment only,” the researchers concluded.
Steeb T, Schlager JG, Kohl C, Ruzicka T, Heppt MV, Berking C. Laser-assisted photodynamic therapy for actinic keratosis: A systematic review and meta-analysis. J Am Acad Dermatol. 2019;80(4):947-956. doi:10.1016/j.jaad.2018.09.021