Efficacy and Safety of Tacrolimus 0.1% for the Treatment of Facial Vitiligo: A Multicenter Randomized, Double-Blinded, Vehicle-Controlled Study

Sénéschal, Julien; Duplaine, Alexandra; Maillard, H.; Passeron, Thierry; Andreu, Nicolas; Lassalle, R.; Favary, Clélia; Droitcourt, Catherine; Taı̈eb, Alain; Ezzedine, Khaled

doi:10.1016/j.jid.2020.12.028

Cited by 20 publications

(15 citation statements)

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“…Factors that were most commonly associated with significantly higher psychosocial burden included female sex, visible or genital lesions, age < 30 years (particularly adolescents), and extensive body area involvement, among others. The implementation of facial vitiligo as a primary outcome measure in recent clinical studies [178][179][180][181] is supported by the gravity of the association between facial lesions and a higher psychosocial burden reported here. Some of the factors significantly associated with a higher psychosocial burden have been associated with a greater willingness to pay, although the association between willingness to pay and lesion location was not assessed [4].…”

Section: Discussionsupporting

confidence: 63%

Psychosocial Effects of Vitiligo: A Systematic Literature Review

et al. 2021

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Background Patients with vitiligo experience reduced quality of life. Objective To comprehensively describe the available evidence for psychosocial burden in vitiligo. Methods A systematic review of observational studies and clinical trials identified using PubMed, EMBASE, Scopus, and the Cochrane databases was performed through 1 March, 2021, to assess psychosocial comorbidities in vitiligo. Two independent reviewers performed an assessment of articles and extracted data for qualitative synthesis. Results Included studies (N = 168) were published between 1979 and 1 March, 2021; 72.6% were published since 2010. Disorders including or related to depression (41 studies, 0.1-62.3%) and anxiety (20 studies, 1.9-67.9%) were the most commonly reported. The most prevalent psychosocial comorbidities were feelings of stigmatization (eight studies, 17.3-100%), adjustment disorders (12 studies, 4-93.9%), sleep disturbance (seven studies, 4.6-89.0%), relationship difficulties including sexual dysfunction (ten studies, 2.0-81.8%), and avoidance or restriction behavior (12.5-76%). The prevalence of most psychosocial comorbidities was significantly higher vs healthy individuals. Factors associated with a significantly higher burden included female sex, visible or genital lesions, age < 30 years (particularly adolescents), and greater body surface area involvement, among others. The most commonly reported patient coping strategy was lesion concealment. Limitations Available studies were heterogeneous and often had limited details; additionally, publication bias is possible. Conclusions The results of this systematic review show that vitiligo greatly affects psychosocial well-being. The extent of psychosocial comorbidities supports the use of multidisciplinary treatment strategies and education to address the vitiligoassociated burden of disease. Protocol Registration PROSPERO (CRD42020162223).

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Section: Discussionsupporting

confidence: 63%

Psychosocial Effects of Vitiligo: A Systematic Literature Review

et al. 2021

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“…Current treatment options use topical calcineurin inhibitors (e.g., tacrolimus) in treatment of vitiligo [30], which broadly suppresses CD8 + and CD4 + T‐cells, and it may impair pathogen specific T‐cells response leading to skin infections [31], like Streptococcal impetigo [32]. Additionally, the relapse rate for tacrolimus treatment in vitiligo is 40% [33]. Moreover, mice experiments have shown that the treatment also suppresses Tregs' abundance [34].…”

Section: Discussionmentioning

confidence: 99%

Calcium controlled NFATc1 activation enhances suppressive capacity of regulatory T cells isolated from generalized vitiligo patients

Giri

Bharti²,

Begum

et al. 2022

Immunology

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NFATs and FOXP3 are linked with impaired regulatory T-cells (Tregs) in generalized vitiligo (GV). To elucidate calcium mediated NFATc1 signalling pathway and its effect on Treg suppressive capacity in GV. Calcium levels, calcineurin, NFATc1 and GSK-3β activity and cell proliferation were assessed in 52 GV patients and 50 controls by calcium assay kit, calcineurin phosphatase assay kit, TransAM NFATc1 kit, GSK-3β ELISA and BrdU cell proliferation assay. Transcripts (CNB, CAM, GSK3B, DYRK1A and calcium channel genes) and protein (IFN-γ, IL-10 and TGF-β) expressions were assessed by qPCR and ELISA, respectively. Reduced plasma and intracellular Tregs calcium levels and ORAI1 transcripts suggested altered calcium homeostasis in GV Tregs (p = 0.00387, p = 0.0048, p < 0.0001), which led to decreased calcineurin and NFATc1 activity in GV Tregs (p = 0.0299, p < 0.0001). CNB and CAM transcripts were reduced in GV Tregs (p < 0.0001, p = 0.0004). GSK-3β activity, GSK3B and DYRK1A transcripts significantly

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“…followed up 25 cosmetically acceptable repigmentation patients in an 84 narrowband UVB‐treated cohort study and revealed a 72% relapse within 3.5 years whilst a 44% relapse within one year. Seneschal et al 9 . also displayed a 40% relapse at 48 weeks in a multicenter, randomized, double‐blinded, vehicle‐controlled clinical trial.…”

Section: Discussionmentioning

confidence: 93%

Recurrence and risk factors in cured patients with vitiligo: A real‐life single‐center retrospective study

Qiu

et al. 2023

J of Cosmetic Dermatology

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Background The risk of recurrence after successful repigmentation in vitiligo has attracted attention from both patients and clinicians. Objectives The recurrence rate and risk factors in cured patients with vitiligo were analyzed to improve clinical prevention and treatment. Methods Clinical records of 76 patients with vitiligo who demonstrated at least 80% repigmentation were analyzed retrospectively. Single‐factor analysis of variance and binary logistic regression analysis was employed to screen the risk factors of vitiligo recurrence. Results Among the 76 cured patients, 26 relapsed (total recurrence rate of 34.2%). Among these, 20 relapsed within one year (recurrence rate of 26.3%). Single‐factor analysis of variance revealed significant differences (p < 0.05) with the age of onset (yr), distribution of onset, and oral traditional Chinese medicine (TCM) intake between the recurrence and nonrecurrence groups. Binary logistic regression analysis displayed that the age of onset (yr) (p = 0.015, OR = 1.051), distribution of onset (p = 0.046, OR = 0.194), and oral TCM (p = 0.018, OR = 4.360) are significant risk factors for vitiligo recurrence. Conclusion A total relapse rate of 34.2% was observed in cured vitiligo patients. The age of onset (yr), distribution of onset, and oral TCM are risk factors for vitiligo recurrence. The necessary interventions should be considered on these factors for reducing the recurrence rate of vitiligo.

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Efficacy and Safety of Tacrolimus 0.1% for the Treatment of Facial Vitiligo: A Multicenter Randomized, Double-Blinded, Vehicle-Controlled Study

Cited by 20 publications

References 22 publications

Psychosocial Effects of Vitiligo: A Systematic Literature Review

Psychosocial Effects of Vitiligo: A Systematic Literature Review

Calcium controlled NFATc1 activation enhances suppressive capacity of regulatory T cells isolated from generalized vitiligo patients

Recurrence and risk factors in cured patients with vitiligo: A real‐life single‐center retrospective study

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