Author Interviews, Dermatology, JAMA / 01.06.2019
Vitiligo: Off Label Topical Calcineurin Inhibitors Help Some Patients
MedicalResearch.com Interview with:
[caption id="attachment_49481" align="alignleft" width="150"]
Dr. Jung Min Bae[/caption]
Jung Min Bae, MD, PhD
Associate Professor, Department of Dermatology
St. Vincent's Hospital
College of Medicine, The Catholic University of Korea
MedicalResearch.com: What is the background for this study?
Response: Vitiligo is a common chronic skin disease affecting 1% of the population, and it causes low self-esteem and social stigma. To date, there are no approved drugs for the treatment of vitiligo, even though growing evidence indicates favorable therapeutic responses of topical calcineurin inhibitors (TCIs) including tacrolimus and pimecrolimus.
In this study, we conducted a systematic review and meta-analysis of all relevant prospective studies (n = 46) and identified remarkable therapeutic responses of TCI monotherapy and TCI plus phototherapy for vitiligo.
Dr. Jung Min Bae[/caption]
Jung Min Bae, MD, PhD
Associate Professor, Department of Dermatology
St. Vincent's Hospital
College of Medicine, The Catholic University of Korea
MedicalResearch.com: What is the background for this study?
Response: Vitiligo is a common chronic skin disease affecting 1% of the population, and it causes low self-esteem and social stigma. To date, there are no approved drugs for the treatment of vitiligo, even though growing evidence indicates favorable therapeutic responses of topical calcineurin inhibitors (TCIs) including tacrolimus and pimecrolimus.
In this study, we conducted a systematic review and meta-analysis of all relevant prospective studies (n = 46) and identified remarkable therapeutic responses of TCI monotherapy and TCI plus phototherapy for vitiligo. 
Dr. Jung Min Bae[/caption]
MedicalResearch.com Interview with:
Jung Min Bae, MD, PhD
Department of Dermatology, St. Vincent's Hospital,
College of Medicine
The Catholic University of Korea,
Suwon Korea
Medical Research: What is the background for this study?
Response: Vitiligo is one of the major challenging skin diseases. Although a number of interventions have been done in the treatment of vitiligo, no definitive curative treatment exists. Narrowband ultraviolet B phototherapy is considered the mainstay of vitiligo treatment, and 308-nm excimer laser/light therapy has gained popularity for localized vitiligo. However, they are not effective in all patients with vitiligo, and the combination therapies with topical agents are widely applied to increase the response rates of these treatment modalities in clinical practice. We sought to compare the efficacy of excimer laser/light and topical agent combination therapy versus excimer laser/light monotherapy for vitiligo. We performed a systematic review and meta-analyses of randomized controlled trials in this subject.
Medical Research: What are the main findings?
Response: According to our study, the combination therapy of excimer laser/light and topical calcineurin inhibitors showed almost a two-fold increase in treatment success rate (≥75% repigmentation) compared to excimer laser/light monotherapy (relative risk 1.93). The combination therapy also reduced the treatment failure rate (<25% repigmentation) by almost half (relative risk 0.43). Addition of topical vitamin-D3 analogs or topical corticosteroids on excimer laser/light showed insufficient evidence to support their use in combination therapies yet. Considering the difficulites in complete recovery of vitiligo, the combination therapies enhancing the treatment response are promising.