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The efficacy of 308-nm excimer laser/light (EL) and topical agent combination therapy versus EL monotherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials (RCTs).
J Am Acad Dermatol. 2016 May; 74(5):907-15.JA

Abstract

BACKGROUND

Combination therapies of excimer laser/light (EL) and various topical agents are widely used in the treatment of vitiligo.

OBJECTIVE

We sought to compare the efficacy of EL and topical agent combination therapy versus EL monotherapy for vitiligo.

METHODS

Manual searches of reference lists and computerized searches of the MEDLINE, EMBASE, and Cochrane library (from inception through December 15, 2014) were conducted to identify randomized controlled trials that assessed the efficacy of EL alone or in combination with topical agents for vitiligo. The primary outcome was treatment success (≥75% repigmentation), and the secondary outcome was treatment failure (<25% repigmentation); meta-analyses were performed when possible.

RESULTS

We analyzed 8 randomized controlled trials comprising a total of 425 patches/patients. The combination of EL and topical calcineurin inhibitors (4 studies: relative risk 1.93, 95% confidence interval 1.28-2.91; number needed to treat 4.5, 95% confidence interval 2.9-10) was superior to EL monotherapy for vitiligo. There was insufficient evidence to support beneficial effects of topical vitamin-D3 analogs (3 studies) and corticosteroids (1 study).

LIMITATIONS

These findings are based on small numbers of randomized controlled trials and heterogeneities among included studies are another limitation.

CONCLUSION

Topical calcineurin inhibitors in conjunction with EL are more effective compared with EL monotherapy.

Authors+Show Affiliations

Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. Electronic address: jminbae@gmail.com.Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. Electronic address: dermabae@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

26785803

Citation

Bae, Jung Min, et al. "The Efficacy of 308-nm Excimer Laser/light (EL) and Topical Agent Combination Therapy Versus EL Monotherapy for Vitiligo: a Systematic Review and Meta-analysis of Randomized Controlled Trials (RCTs)." Journal of the American Academy of Dermatology, vol. 74, no. 5, 2016, pp. 907-15.
Bae JM, Hong BY, Lee JH, et al. The efficacy of 308-nm excimer laser/light (EL) and topical agent combination therapy versus EL monotherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials (RCTs). J Am Acad Dermatol. 2016;74(5):907-15.
Bae, J. M., Hong, B. Y., Lee, J. H., Lee, J. H., & Kim, G. M. (2016). The efficacy of 308-nm excimer laser/light (EL) and topical agent combination therapy versus EL monotherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials (RCTs). Journal of the American Academy of Dermatology, 74(5), 907-15. https://doi.org/10.1016/j.jaad.2015.11.044
Bae JM, et al. The Efficacy of 308-nm Excimer Laser/light (EL) and Topical Agent Combination Therapy Versus EL Monotherapy for Vitiligo: a Systematic Review and Meta-analysis of Randomized Controlled Trials (RCTs). J Am Acad Dermatol. 2016;74(5):907-15. PubMed PMID: 26785803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The efficacy of 308-nm excimer laser/light (EL) and topical agent combination therapy versus EL monotherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials (RCTs). AU - Bae,Jung Min, AU - Hong,Bo Young, AU - Lee,Joo Hee, AU - Lee,Ji Hae, AU - Kim,Gyong Moon, Y1 - 2016/01/16/ PY - 2015/04/28/received PY - 2015/10/20/revised PY - 2015/11/09/accepted PY - 2016/1/21/entrez PY - 2016/1/21/pubmed PY - 2016/9/3/medline KW - excimer laser KW - laser KW - pimecrolimus KW - tacrolimus KW - topical calcineurin inhibitor KW - vitiligo SP - 907 EP - 15 JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. VL - 74 IS - 5 N2 - BACKGROUND: Combination therapies of excimer laser/light (EL) and various topical agents are widely used in the treatment of vitiligo. OBJECTIVE: We sought to compare the efficacy of EL and topical agent combination therapy versus EL monotherapy for vitiligo. METHODS: Manual searches of reference lists and computerized searches of the MEDLINE, EMBASE, and Cochrane library (from inception through December 15, 2014) were conducted to identify randomized controlled trials that assessed the efficacy of EL alone or in combination with topical agents for vitiligo. The primary outcome was treatment success (≥75% repigmentation), and the secondary outcome was treatment failure (<25% repigmentation); meta-analyses were performed when possible. RESULTS: We analyzed 8 randomized controlled trials comprising a total of 425 patches/patients. The combination of EL and topical calcineurin inhibitors (4 studies: relative risk 1.93, 95% confidence interval 1.28-2.91; number needed to treat 4.5, 95% confidence interval 2.9-10) was superior to EL monotherapy for vitiligo. There was insufficient evidence to support beneficial effects of topical vitamin-D3 analogs (3 studies) and corticosteroids (1 study). LIMITATIONS: These findings are based on small numbers of randomized controlled trials and heterogeneities among included studies are another limitation. CONCLUSION: Topical calcineurin inhibitors in conjunction with EL are more effective compared with EL monotherapy. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/26785803/The_efficacy_of_308_nm_excimer_laser/light__EL__and_topical_agent_combination_therapy_versus_EL_monotherapy_for_vitiligo:_A_systematic_review_and_meta_analysis_of_randomized_controlled_trials__RCTs__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(15)02530-X DB - PRIME DP - Unbound Medicine ER -