Zhu et al (2023) noted that vitiligo is an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance re-pigmentation. In a systematic review and network meta-analysis, these researchers compared the effectiveness of current NB-UVB combination regimen at the improvement in re-pigmentation. They searched the electronic databases for RCTs related to NB-UVB combination therapy for vitiligo till October 2022; STATA15.0 software was employed to conduct data analysis. A total of 28 eligible studies involving 1,194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy (OR = 32.35, 95 % CI: 1.79 to 586.05), Er: YAG laser+ topical 5% 5-FU (OR = 10.74, 95 % CI: 4.05 to 28.49), needling/micro-needling (OR = 3.42, 95 % CI: 1.18 to 9.88), betamethasone intra-muscular injection (OR = 3.08, 95 % CI: 1.17 to 8.13), topical tacrolimus (OR = 2.54, 95 % CI: 1.30 to 4.94), and oral Chinese herbal medicine compound (OR = 2.51, 95 % CI: 1.40 to 4.50) integrated with NB-UVB were more effective in excellent to complete re-pigmentation response rate (75 %or higher). In addition, NB-UVB+ Er: YAG laser+ topical 5 % 5-FU (OR = 0.17, 95 % CI: 0.04 to 0.67) and NB-UVB+ needling/micro-needling (OR = 0.24, 95 % CI: 0.06 to 0.88) were less likely evaluated as ineffective re-pigmentation response (25 % or less). The authors concluded that all combination therapies ranked higher than NB-UVB monotherapy in inducing successful re-pigmentation and avoiding failed treatment in patients with vitiligo. Comprehensive consideration, NB-UVB+ Er: YAG laser+ topical 5 % 5-FU and NB-UVB+ needling/micro-needling would be the preferred therapeutic approaches.
Published on February 23, 2024
Comparison of NB-UVB Combination Therapy Regimens for the Treatment of Vitiligo
References
- https://www.aetna.com/cpb/medical/data/400_499/0422.html
- Zhu B, Liu C, Zhang L, et al. Comparison of NB-UVB combination therapy regimens for vitiligo: A systematic review and network meta-analysis. J Cosmet Dermatol. 2023;22(3):1083-1098.