The addition of topical calcipotriol to phototherapy enhance the efficacy of treatment in patients with vitiligo: A systematic review and meta-analysis

Int Immunopharmacol. 2021 Sep:98:107910. doi: 10.1016/j.intimp.2021.107910. Epub 2021 Jun 28.

Abstract

Background: Treatment of vitiligo has several challenges. Phototherapy and topical calcipotriol have been reported to be effective in combination with other therapies, but there is no consensus on the combination use.

Objective: To perform a systematic review and meta-analysis that elucidates the efficacy of the combination of phototherapy and topical calcipotriol.

Methods: This systematic review was performed by searching PubMed, EMBASE, Web of Science, Cochrane Library databases, Chinese National Knowledge Infrastructure (CNKI), WanFang and VIP databases for relevant publications till February 28, 2021. Relative risk (RR) and its 95% confidence interval (CI) were used to evaluate the data. Bias assessment, heterogeneity and sensitivity analysis were conducted in this meta-analysis.

Results: After screening, nine studies with 700 participants were included. The meta-analysis indicated that the combination of phototherapy and topical calcipotriol showed significantly higher effective rate (RR 1.11, 95% CI 1.02-1.22; p < 0.05) and apparent effective rate (RR 1.35, 95% CI 1.15-1.59; p < 0.01) than phototherapy monotherapy in the treatment of vitiligo. In addition, the side effects were minor, transient and tolerable.

Conclusions: This meta-analysis provides evidence supporting phototherapy combined with topical calcipotriol as a valuable treatment modality for patients with vitiligo, which has better efficacy than monotherapy.

Keywords: 308 nm excimer laser; Calcipotriol; Narrowband ultraviolet B; Phototherapy; Psoralen ultraviolet A; Vitiligo.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Administration, Cutaneous
  • Calcitriol / administration & dosage
  • Calcitriol / analogs & derivatives*
  • Combined Modality Therapy
  • Dermatologic Agents / administration & dosage*
  • Humans
  • Lasers, Excimer
  • Low-Level Light Therapy / instrumentation
  • Low-Level Light Therapy / methods*
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Skin Pigmentation / drug effects
  • Skin Pigmentation / radiation effects
  • Treatment Outcome
  • Vitiligo / diagnosis
  • Vitiligo / therapy*

Substances

  • Dermatologic Agents
  • calcipotriene
  • Calcitriol