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

Abstract

Aims and objectivesThe purpose of this study is to investigate the effectiveness and safety of oral and injectable systemic treatments, such as methotrexate, azathioprine, cyclosporine, tofacitinib, baricitinib, corticosteroids, statins, zinc, apremilast, etc., for treating vitiligo lesions.MethodDatabases including PubMed, Scopus, and Web of Science were meticulously searched for studies spanning from 2010 to August 2023, focusing on systemic oral and injectable therapies for vitiligo, using comprehensive keywords and search syntaxes tailored to each database. Key data extracted included study design, treatment efficacy, patient outcomes, patient satisfaction, and safety profiles.ResultsIn a total of 42 included studies, oral mini‐pulse corticosteroid therapy (OMP) was the subject of six studies (14.2%). Minocycline was the focus of five studies (11.9%), while methotrexate, apremilast, and tofacitinib each were examined in four studies (9.5%). Antioxidants and Afamelanotide were the subjects of three studies each (7.1%). Cyclosporine, simvastatin, oral zinc, oral corticosteroids (excluding OMP) and injections, and baricitinib were each explored in two studies (4.8%). Azathioprine, mycophenolate mofetil, and Alefacept were the subjects of one study each (2.4%).ConclusionSystemic treatments for vitiligo have been successful in controlling lesions without notable side effects. OMP, Methotrexate, Azathioprine, Cyclosporine, Mycophenolate mofetil, Simvastatin, Apremilast, Minocycline, Afamelanotide, Tofacitinib, Baricitinib, Antioxidants, and oral/injectable corticosteroids are effective treatment methods. However, oral zinc and alefacept did not show effectiveness.

Combination of total glucosides of paeony, narrow‐band ultraviolet B, and oral corticosteroid mini‐pulse therapy for nonsegmental vitiligo: A retrospective study

“…systematically reviewed various studies of oral or injectable treatments for vitiligo and showed that different doses of OMP therapy produced significantly effective results. 21 However the specific drugs used for OMP therapy are different in different literature and our study provides new insights into the addition of methylprednisolone to OMP therapy. In addition, they found that Methotrexate, Azathioprine, Cyclosporine, Mycophenolate mofetil, Simvastatin, Apremilast, Minocycline, Afamelanotide, Tofacitinib, Baricitinib, Antioxidants, and oral and injectable forms of CSs are all effective in the treatment of vitiligo, so future research directions should favor a comparison of the safety and efficacy of TGP in combination with these drugs.…”

Regenerative medicine in the treatment of specific dermatologic disorders: a systematic review of randomized controlled clinical trials

“…These treatments have been extensively investigated for a wide range of skin diseases, which can be categorized into two main groups: primary skin diseases, including androgenetic alopecia [ 6 , 7 ], vitiligo [ 8 , 9 ], alopecia areata [ 10 ], telogen effluvium [ 11 ], melasma [ 12 ], acne vulgaris [ 13 ], lichen sclerosus et atrophicus (LSA) [ 14 ], erosive oral lichen planus [ 15 , 16 ], and dystrophic epidermolysis bullosa [ 17 ]; and skin conditions secondary to damage such as acne scars, hypertrophic scars from burns, erosions, and ulcers [ 18 ].…”