A Comparison of Betamethasone Valerate 0.1% Cream Twice Daily Plus Oral Simvastatin Versus Betamethasone Valerate 0.1% Cream Alone in the Treatment of Vitiligo Patients

Abstract

Background:Vitiligo, a common disorder of depigmentation, is often difficult to treat. Corticosteroids are known to be effective, but with modest results. Although simvastatin has been reported to be effective for immunorelated dermatologic disorders including vitiligo, controlled trials are lacking. This study was conducted to compare the efficacy of topical betamethasone valerate 0.1% cream (as a standard method of treatment for vitiligo) versus a combination of betamethasone valerate plus oral simvastatin in the treatment of vitiligo.Materials and Methods:Eighty-eight subjects with symmetric vitiligo who had body surface involvement up to 20% were divided randomly into two groups. Group A were treated with betamethasone valerate 01% cream twice daily and Group B with betamethasone valerate 01% cream twice daily and oral simvastatin 80 mg daily for 12 weeks. Finally, 46 patients completed treatment after 12 weeks in both groups. The results were evaluated by a blind dermatologist using Vitiligo Area Scoring Index (VASI) score at baseline, 4th, 8th, and 12th week of treatment. In a similar way, subjective assessment performed by patients based on photo evaluation at the end of the study.Results:Despite a continuous reduction in VASI score in both groups, according to both physician (P = 0.13) and patient (P = 0.374) assessment oral simvastatin was not statistically more effective than conventional treatment of vitiligo.Conclusion:This study indicates that oral simvastatin is not associated with significant impacts in the treatment of vitiligo as compared to other inflammatory dermatologic conditions such as psoriasis. Indeed, other studies should be initiated regarding exact molecular and cellular effects of statins in the treatment of vitiligo.

A systematic review of case series and clinical trials investigating systemic oral or injectable therapies for the treatment of vitiligo

“…Conversely, another study found that administering Simvastatin at a dosage of 80 mg/day did not demonstrate a statistically significant improvement compared to conventional treatment for vitiligo. The study concluded that oral Simvastatin did not have a significant impact on the treatment of vitiligo 28 …”

“…51,52 One of the two studies that were examined showed that simvastatin was effective, 27 while the other study did not show any significant improvement. 28 Based on these findings, it cannot be denied that the drug is effective, but it may be a good treatment option for patients who have high cholesterol levels or are at risk of cardiovascular events.…”

Efficacy and Safety of Oral Simvastatin in the Treatment of Patients with Vitiligo

“…Vanderweil et al 13 conducted a randomized, double-blind, placebo-controlled, phase II clinical trial in which the treatment group was administered 40 mg simvastatin daily for the first month and 80 mg for the following 5 months, whereas the control group was given placebo. Iraji et al 14 reported that patients with vitiligo were randomized to either 0.1% betamethasone valerate cream for external use two times per day alone or in combination with 80 mg oral simvastatin daily. Nguyen et al 15 conducted a randomized clinical trial evaluating the effectiveness of a combination of 40 mg oral atorvastatin daily for 1 month followed by 80 mg oral atorvastatin daily for 5 months and narrow-band ultraviolet B (NB-UVB) phototherapy twice per week for 6 months versus NB-UVB phototherapy alone twice per week for 6 months in patients with active vitiligo.…”

Pharmacological and pharmaceutical technological overview for seborrheic dermatitis: a review about topical application and new approaches

“…It has anti-inflammatory and antipruritic effect. 12 Cetrimide: This drug is a quaternary ammonium derivative and antiseptic. Shampoos containing 1 to 3% of cetirimide are used against perspiration in case of SD.…”