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UVB phototherapy for participants with an early form of multiple sclerosis

Investigators: Anderson Jones, Matt Cooper, Prue Hart, Stephanie Trend

External collaborators: Robyn Lucas (Australian National University), Scott Byrne (University of Sydney), Allan Kermode (Perron Institute, Murdoch University), David Booth (University of Sydney)

Latitude gradients for the incidence and prevalence of multiple sclerosis (MS) are well established, with more disease at higher latitudes where there is reduced sun. Exposure to sun has been linked with the initiation and progression of MS, and there is evidence that sun exposure is important at all stages of life for MS pathogenesis, even in utero. Seasonal effects on MS disease activity have also been described. Many believe that a lack of UV-induced vitamin D is responsible, but vitamin D supplementation trials have not shown the reduced disease progression that was hoped for. We propose that UV via vitamin D-independent pathways may be responsible.

We believe that this is the first trial in the world of UVB phototherapy for participants with Clinically Isolated Syndrome. The trial is called PhoCIS as it is Phototherapy for participants with Clinically Isolated Syndrome.

Patients are not diagnosed with multiple sclerosis until they have had two demyelinating (clinical) events. In the PhoCIS trial, we are recruiting individuals who have had only one event as we believe that if we can catch them very early in their disease progression, we can dampen it or halt its course. We give them phototherapy over the first 2 months and follow the cells in their blood, and images of their brain, for the next 12 months. The phototherapy is delivered in a dermatologists rooms and is similar to that given to patients with the skin condition, psoriasis.