C. J. Arora1, S. Shumack2
Background/Objectives: There is no deﬁnitive remedy for vitiligo and various treatment modalities are currently available such as immune mediators, phototherapy, and skin camouﬂage. We investigated the efﬁcacy and safety of topical tacrolimus either as monotherapy or combined therapy in the treatment of human vitiligo.
Methods: Electronic systematic search of the literature was carried out using four major databases. Randomized clinical trials (RCTs) that reported the use of topical tacro- limus 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).
Results: A total of 19 studies including 814 patients were included in our systematic review. The random-model meta-analysis of two studies revealed that the tacrolimus and narrow Band ultra violet B (NB-UVB) combination therapy is better than NB-UVB alone in inducing > 75% repigmentation [RR (95% CI) = 1.34 (01.05–1.71), p = 0.02]. Tacrolimus and steroids had similar potency in obtain- ing > 75% repigmentation [RR (95% CI) = 1.02 (0.19–5.51), p = 0.98]. Meta-analysis of two studies revealed that the fractional laser and tacrolimus combination therapy is bet- ter than tacrolimus alone in causing > 75% repigmentation [RR (95% CI) = 2.11 (0.87–5.09), p = 0.10].
Conclusion: Further-investigating tacrolimus as mono- or adjuvant therapy for vitiligo is highly recommended. Com- bining tacrolimus to other treatment options such as ster- oids, phototherapy, and laser may be superior to using tacrolimus alone.
A non-interventional-prospective-12-month study to characterise REAL-life effectiveness and treatmentpatterns of secukinumab, and current standard-of-care of chronic plaque psoriasis in Asia-Pacific & MiddleEast