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Can Calcineurin Inhibitors Effectively Treat Vitiligo?

Topical calcineurin inhibitors (TCIs) appear to effectively treat vitiligo, according to the findings of a recent study.

“TCIs, including tacrolimus and pimecrolimus, have been widely used for the treatment of vitiligo; however, the efficacy of TCI monotherapy is often underestimated,” the researchers said.
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In the review, the researchers analyzed 46 studies, with 1499 participants, that assessed either TCI mechanisms, TCI as monotherapy, TCI plus phototherapy, and maintenance TCI therapy. Rates of at least mild (25% or less), at least moderate (50% or less), and marked (75% or less) repigmentation responses were assessed as the primary outcomes.

Among studies that assessed TCI monotherapy, the researchers found 55% of 560 participants in 21 studies achieved at least mild response; 38.5% of 619 participants in 23 studies achieved at least moderate response; and 18.1% of 520 participants in 19 studies achieved a marked response after median treatment duration of 3 months.

Subgroup analyses showed at least mild response in 73.1% of participants with face and neck lesions and marked response in 35.4% of participants with face and neck lesions, the researchers said.

At least mild response and marked response was achieved by 89.5% and 47.5% of participants, respectively, treated with TCI plus phototherapy, the researchers said.

“The use of TCIs, both as a monotherapy and in combination with phototherapy, should be encouraged in patients with vitiligo,” the researchers concluded.

Reference

Lee JH, Kwon HS, Jung HM, et al. Treatment outcomes of topical calcineurin inhibitor therapy for patients with vitiligo: A systematic review and meta-analysis [Published online May 29, 2019]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.0696

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