Clinical Efficacy

Clinical Papers

Comparative Features of MAVENA ® Balneo-Phototherapy to other forms of therapy
Place of Balneo-phototherapy in disease management
   
 

Balneo-Phototherapy, which combines the gentleness of a brine soak with the therapeutic power of ultraviolet phototherapy (ultraviolet B), provides effective, well-tolerated therapy for patients with chronic inflammatory skin diseases such as psoriasis and atopic dermatitis.

For centuries, this therapy has been successfully practised at the Dead Sea providing therapeutic benefits to patients with psoriasis, atopic dermatitis and other skin diseases. Magnesium and mineral-intense waters are associated with beneficial activity against the cellular mechanisms of psoriasis and inflammation.

By recreating the natural conditions of the Dead Sea with brine baths followed by UV radiation, MAVENA AG has brought the balneo phototherapeutic concept to local out-patient therapy centres. Patients can now achieve maximum mineral and phototherapy benefits in a controlled, hygienic environment under the supervision of a dermatologist, allowing therapy to be tailored to their individual needs.

Additionally, our treatment concept offers education, life style counselling and psychological support. Mavena ® Derma Clinics proposes an holistic treatment, natural and safe, for chronic skin diseases like psoriasis and atopic Dermatitis. The relaxing clinic setting enhances physical and psychological well being.

The uniqueness of the Dead Sea as an effective brine soak lies with its high salt concentration and in particular, its high magnesium content. The electronically controlled, filter purified bathing system from MAVENA ® provides a salty bath with a 5% up to 15% brine solution, depending on type and severity of disease, that is enriched with a high magnesium content (>46%). In addition to the physical effect of the minerals on afflicted skin, patients also benefit from the soothing flow and whirl of the water, which offers the relaxation needed to reduce stress-associated with atopic dermatitis and psoriasis. The bath is then followed by a course of Narrow Band UVB or/and UVA phototherapy standardised to a patient’s unique skin characteristics and clinical needs. 

Therapeutic effect of brine

Salts used in the MAVENA ® system are pure compounds that ensure reproducible composition of the salty bath. High salinity has been shown to have keratolytic effects, softening the horny layer of the skin to allow penetration of minerals and magnesium, as well as anti proliferative effects. It also elutes a high amount of the harmful human leukocyte elastase from psoriatic lesions. Furthermore, bathing in salt solution  can increase the photo-sensitivity of the skin, thus maximising photo-therapy treatment. The association  between high magnesium concentration and anti-inflammatory effects has also been demonstrated in animal models. Salt also acts as a surface disinfectant and stimulates blood flow within the skin, which provides a healthy and holistic treatment approach.

Clinical Efficacy
 


The clinical efficacy of MAVENA ® Balneo-Phototherapy is measured by the recognised clinical scores -  Psoriasis Area Severity Index (PASI) for psoriasis and Score of Atopic Dermatitis (SCORAD) for atopic  dermatitis. It compares favourably with the Dead Sea treatment regimens.

Balneo-Phototherapy treatment results have been analysed for 328 full body psoriasis patients. The patients underwent an average of 30 Balneo-Phototherapy sessions. (bath concentration 15% Sea of Life Dead Sea salt) in the MAVENA ® Derma Clinic in Magdeburg (Germany). The mean reduction in PASI-Score was 87,4%.

Balneo-Phototherapy (bath concentration 5% Sea of life  Dead Sea salt and UVA phototherapy) for 79 patients  presenting with chronic atopic dermatitis resulted in a mean reduction of 58,7% in SCORAD-score

Clinical Papers
 


Buntrock S, Meffert H, Lehner T, et al. Balneophototherapy der Psoriasis - ein System zur ambulante Behandlung [Balneophototherapy for psoriasis - a method for ambulant treatment]. Dermatol Monatssschr, 1993; 179:128-131

Coven TR, Burack LH, Gilleaudeau R, et al. Narrowband UV-B produces superior clinical and histopathological resolution of moderate-to-severe psoriasis in patients compared with broadband UV-B. Arch Dermatol, 1997; 133(12):1514-1522

David JA and Vitaly K. Bioclimatology and Balneology in Dermatology: A Dead Sea perspective. Clin Dermatol, 1998; 16:995-698

David M, Efron D, Hodak E, et al. Treatment psoriasis at the Dead Sea: Why, How and When? Isr Med Assoc J, 2000; 2(3):232-234

Diezel W, Schewe T, Schulz E et al. Magnesium-Ionen: Entzüdungshemmende Wirkungen and äusserliche therapeutische Anwendung [Magnesium ions anti-inflammatory effect and external therapeutic application]. Hautnah Dermatologie, 1994; 4:376-382

Drnagl K. Wirkungsmechanismus von Solequellen [Mechanisms of effectivness of brine springs]. Z Angew Bäder Klimaheilk, 1978; 25:225-235

Griffiths CE, Clark CM, Chalmers RJ, et al. Systematic review of treatments for severe psoriasis. Health Technol Assess, 2000; 4(40):1-125

Ludwig P, Petrich K, Schewe T, et al. Inhibition of eicosanoid formation in human polymorphonuclear leucocytes by high concentrations of magnesium ions. Biol Chem Hoppe-Seyler, 1995; 376:739-744

Parrish JA and Jaenicke KF. Action Spectrum for phototherapy of psoriasis. J Invest Dermatol, 1981; 76:359-362

Schempp CM, Dittmar HC, Hummler D, et al. Magnesium ions inhibit the antigen-presenting function of human epidermal Langerhans cells in vivo and in vitro. Involvement of ATPase, HLA-DR, B7 molecules, and cytokines. J Invest Dermatol, 2000; 115(4):680-686

Shani J, Sharon R, Koren R, et al. Effect of Dead-Sea Brine and its main salts on cell growth in culture. Pharmacology, 1987; 35:339-347

Storbeck K, Holzle E, Schurer N, et al. Narrow-band UVB (311 nm) versus conventional broad-band UVB with and without dithranol in phototherapy for psoriasis. J Am Acad Dermatol, 1993; 28(2 Pt 1):227-231

Tanew A, Radakovic-Fijan S, Schemper M, et al. Narrowband UV-B phototherapy vs photochemotherapy in the treatment of chronic plaque-type psoriasis: a paired comparison study. Arch Dermatol, 1999; 135(5):519-524

Walters IB, Burack LH, Coven TR, et al. Suberythemogenic narrow-band UVB is markedly more effective than conventional UVB in treatment of psoriasis vulgaris. J Am Acad Dermatol, 1999; 40(6 Pt 1):893-900

Wiedow O, Wiese F, Streit V, et al. Lesional elastase activity in psoriasis, contact dermatitis, and atopic dermatitis. J Invest Dermatol, 1992; 99:306-309

Wiedow O, Streit V, Christophers E, et al. Freisetzung von humaner Leukozytenelastase durch hypertone Salzbäder bei Psoriasis. Hautarzt, 1989; 40:518-522

Zimmermann J and Utermann S. Balneophototherapy in patients with psoriasis and atopic neurodermatitis. Hautarzt, 1994; 45:849-853



Comparative Features of MAVENA ® Balneo-Phototherapy to other forms of therapy
 


MAVENA ® Balneo-Phototherapy does not require the administration of chemicals such as psoralen to enhance the effect of radiation. Thus, the potential side effects of hypersensitivity, increased risk of skin cancer , radiation burn, and possible drug interactions are reduced. Moreover, Balneo-Phototherapy does not requires specific laboratory tests surveillance or eye  examination during treatment as for PUVA therapy.

MAVENA ® Balneo-Phototherapy administered at local clinics does not incur the expense of long distance travel and prolonged stay away from home and work, that is required for treatment at the Dead Sea. Furthermore, the high, magnesium-rich salinity and UVB/UVA phototherapy are controlled and standardised.



Place of Balneo-Phototherapy in disease management
 


Balneo-Phototherapy combining bathing with Dead Sea salt and Narrow Band UVB is suited as first choice  treatment for moderate to severe psoriasis. Patients with a chronic skin condition first consult their  dermatologist who confirms the diagnosis and the suitability of Balneo-Phototherapy for their disease, and refers the patient to the clinic.

In the more severe cases, Balneo-Phototherapy in the convenient ambulatory Mavena ® clinic setting avoids unnecessary hospitalisation.

the Mavena ® Balneo-Phototherapy concept adds to the two pivotal the elements (bathing in Dead Sea salt and Narrow  Band UVB) education, stress management and life style counselling by our medical staff. This holistic approach enhances both physical and psychological well-being.

Advantages for the patient :

 
Mavena ® Balneo-Phototherapy offers a natural and safe treatment for chronic skin diseases like psoriasis and atopic dermatitis.
  Mavena ® Balneo-Phototherapy is a proven treatment having shown excellent clinical performance in Germany for many years.
 
The Mavena ® Derma Clinics activities are led by a qualified dermatologist
 
The relaxing clinic setting offers a unique treatment experience and enhances physical and psychological well-being.
 
The Mavena ® treatment by Balneo-Phototherapy also encompasses education, stress management, life style counselling.
 
Mavena ® Derma Clinics meet a high degree of  acceptance and satisfaction among users: 83% of the patients treated in Mavena ® Derma Clinics would repeat the treatment in case of  reoccurrence.
 
The clinics are in relatively close proximity to the patients.