Preliminary study on the treatment of vitiligo with carbon dioxide fractional laser together with tacrolimus

Chen, Wei; Zhou, Yuan; Huang, Fang; Luo, Dan; Wang, Daguang

doi:10.1002/lsm.22821

Cited by 16 publications

(35 citation statements)

References 31 publications

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“…The study included 45 patients with vitiligo. A better repigmentation occurred in the group treated with CO2 laser and tacrolimus compared with the control group . Tacrolimus and NB‐UVB are well‐established methods for treatment of vitiligo.…”

Section: Discussionmentioning

confidence: 97%

Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment

Ebrahim

Albalate

2020

J of Cosmetic Dermatology

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Background Combination therapies have reported to augment the repigmentation in vitiligo. Microneedling (Mn) facilitates drug delivery across the skin barrier. Objective To evaluate and compare the efficacy and safety of Mn combined with tacrolimus vs Mn alone or tacrolimus 0.1% ointment for treatment of localized and stable vitiligo. Patients and Method Ninety patients with vitiligo were randomized into three groups: group I received microneedling with tacrolimus, group II microneedling only both at 2 weeks interval for twelve sessions, and group III applied tacrolimus ointment 0.1% twice daily for 6 months. Skin biopsies were taken at baseline and after treatment. Results The overall improvement (76.6%) was significantly higher in the combined group compared with other groups. Repigmentation was excellent in 66.6 of group I vs 33.3% in the other two groups (P .03). A highly significant improvement of the extremities was observed in the combined group than in the other groups (P < .001). A fewer number of sessions have reported in the combined group (I) than in the microneedling group (II; P < .001). Immunohistochemical results showed a significantly higher expression of HMB‐45 in group I than in other two groups (P .04). Side effects were mild and tolerable in all groups. Conclusion The combination group has shown promising results over the other two groups.

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Section: Discussionmentioning

confidence: 97%

Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment

Ebrahim

Albalate

2020

J of Cosmetic Dermatology

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“…Manual searching found one further article. Of these 19 RCTs matched the selection criteria . Reasons for excluding 58 papers are detailed in Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen RCTs, published between 2003 and 2018, involving 814 patients, were included; 385 were male (47.29%), with the mean age ranging from 8 to 48.8 years. Five studies were from Pakistan, three from Italy, and two from China.…”

Section: Resultsmentioning

confidence: 99%

“…Blinding of participants and personnel as well as blinding of outcome assessment showed high risk in 12 trials (Fig. ) . All studies, except three, had a low risk of bias with regard to selective reporting …”

Section: Resultsmentioning

confidence: 99%

“…Two studies examined the role of CO 2 fractional laser and tacrolimus combination therapy versus tacrolimus alone in vitiligo patients . The random‐effect model meta‐analysis revealed that the combination was not different from monotherapy in achieving >25% and >75% repigmentation with RR 1.66 (95% CI: 0.86–3.20), P = 0.13 (Fig.…”

Section: Resultsmentioning

confidence: 99%

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The efficacy and safety of tacrolimus as mono‐ and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials

Arora¹,

Rafiq

Shumack

et al. 2019

Aust J Dermatology

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There is currently no definitive treatment for vitiligo; various modalities include immune modulators phototherapy and skin camouflage. We investigated the efficacy and safety of topical tacrolimus either as monotherapy or combined therapy in the treatment of vitiligo. Electronic systematic search of the literature was carried out using four major databases. Randomised clinical trials (RCTs) that reported the use of topical tacrolimus in the treatment of human vitiligo have been included in a systematic review and meta‐analysis. Meta‐analysis was conducted via RevMan, and risk of bias was assessed through the Cochrane quality assessment tool. The protocol was published through PROSPERO (CRD42018112430). A total of 19 studies including 814 patients were included in our systematic review. The random‐effects‐model meta‐analysis of two studies revealed that the tacrolimus and narrowband ultraviolet B (NB‐UVB) combination therapy rates is better than NB‐UVB alone in inducing >75% repigmentation [RR 1.34 (95% CI: 01.05–1.71), P = 0.02]. Tacrolimus and steroids had similar potency in acheiving >75% repigmentation [RR 1.02 (95% CI: 0.19–5.51), P = 0.98]. Meta‐analysis of two studies revealed that the fractional laser and tacrolimus combination therapy is no better than tacrolimus alone in causing >75% repigmentation [RR 2.11 (95% CI: 0.87–5.09), P = 0.10]. Further investigating tacrolimus as mono‐ or adjuvant therapy for vitiligo is highly recommended. Combining tacrolimus to other treatment options such as steroids, phototherapy and laser may be superior to using tacrolimus alone.

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Comparison of 311‐nm Titanium:Sapphire laser and 308‐nm excimer laser treatment for vitiligo: A randomized controlled non‐inferiority trial

et al. 2019

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Objectives: The 308-nm excimer laser (EL) has been widely used for localized vitiligo. The recently developed Titanium:Sapphire laser, emits a wavelength of 311 nm, would be expected to be as effective as excimer laser in treatment of vitiligo but few controlled trials have been reported. We sought to compare the efficacy and safety of the TSL and EL as vitiligo treatments. Methods: A randomized controlled non-inferiority trial based on split-body was conducted. Patients with stable vitiligo between June 2016 and May 2017 were enrolled. Paired symmetrical vitiligo lesions were randomized to either the EL or TSL treatment group, and treated with a 308-nm EL or a 311-nm TSL twice weekly for 12 weeks. The extent of repigmentation was assessed every 4 weeks, and the non-inferiority margin was set to 10%. We also recorded any adverse events. Results: Seventy-four paired lesions in 21 patients were assigned to both the EL group or TSL group. The mean difference between two groups (EL minus TSL) was À2.862%, and the 95% confidence interval (À6.531% to 0.807%) was lower than the non-inferiority margin. No serious adverse events were noted in either group. Conclusions: The Titanium:Sapphire laser showed similar therapeutic effect to excimer laser in localized vitiligo with good safety profiles in this non-inferiority randomized controlled trial. The Titanium: Sapphire laser can serve as an alternative treatment option for localized vitiligo. Lasers Surg. Med. 51:239-244, 2019.

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Preliminary study on the treatment of vitiligo with carbon dioxide fractional laser together with tacrolimus

Cited by 16 publications

References 31 publications

Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment

Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment

The efficacy and safety of tacrolimus as mono‐ and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials

Comparison of 311‐nm Titanium:Sapphire laser and 308‐nm excimer laser treatment for vitiligo: A randomized controlled non‐inferiority trial

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