Compared to monotherapy with NB-UVB, combination treatments are more effective at promoting successful repigmentation and preventing treatment failure in vitiligo patients.
Vitiligo is characterized as an autoimmune disorder. Some management guidelines regarding vitiligo suggest the utilization of narrowband ultraviolet B (NB-UVB) combination therapies to promote skin repigmentation. This systematic review and meta-analysis, published in the Journal of Cosmetic Dermatology, aimed to evaluate the effectiveness of NB-UVB combination therapies for improving skin repigmentation in vitiligo patients.
The meta-analysis included a total of 28 studies with 1194 participants. The network meta-analysis compared NB-UVB with needling/microneedling, topical tacrolimus, oral Chinese herbal medicine, betamethasone intramuscular injection, carboxytherapy, and YAG laser with topical 5% 5-fluorouracil (5-FU) integrated with NB-UVB.
The network meta-analysis results revealed that combination therapies were more effective compared to monotherapy with NB-UVB, with excellent to complete response rates, accounting for ≥ 75%, for repigmentation of skin in vitiligo patients. The meta-analysis also highlighted that two combination therapies: NB-UVB plus topical 5% 5-FU and YAG laser, and NB-UVB plus microneedling/needling, were less likely to be associated with an ineffective treatment response of ≤25%.
In summary, the systematic review and meta-analysis demonstrated that all the combination therapies are more effective, as compared to monotherapy with NB-UVB, at promoting successful repigmentation and preventing treatment failure in vitiligo patients. The preferred combination therapies include NB-UVB with microneedling/needling and NB-UVB with YAG laser and topical 5% 5-FU.
Further clinical trials and case series may compare the effectiveness of NB-UVB combination therapies with surgical approaches in the context of vitiligo management, adverse effects, and treatment outcomes.
Zhu, B., Liu, C., Zhang, L., Wang, J., Chen, M., & Wei, Y. (2022). Comparison of NB-UVB combination therapy regimens for vitiligo: A systematic review and network meta-analysis. J Cosmet Dermatol. https://doi.org/10.1111/jocd.15534