Comparison of efficacy and safety profile for home NB‐UVB vs. outpatient NB‐UVB in the treatment of non‐segmental vitiligo: A prospective cohort study

Abstract

Summary Objective The aim of this study was to evaluate the efficacy and safety of home and outpatient narrowband ultraviolet B light (NB‐UVB) for the treatment of non‐segmental vitiligo. Methods A total of 94 patients with non‐segmental vitiligo were enrolled. Forty‐eight patients were treated with home NB‐UVB, and the other 46 patients were treated with outpatient NB‐UVB over a period of 6 months. The efficacy, patient quality of life, and adverse events were assessed at month 3 and month 6 after treatment. Results There was no significant difference in repigmentation and VASI‐reverse (VR) rates between outpatient NB‐UVB and home NB‐UVB groups. VR was higher in outpatient NB‐UVB group at month 3, and similar at month 6. For long‐standing vitiligo, VR was higher in the outpatient NB‐UVB group compared with home NB‐UVB group after 6 months of treatment. In recent vitiligo, the VR was similar between the two groups. Additionally, vitiligo‐specific health‐related quality‐of‐life instrument (VitiQoL) score was similar, and the adverse effects were minimal among the two groups. Conclusions The efficacy and safety of home NB‐UVB and outpatient NB‐UVB phototherapy for non‐segmental vitiligo were comparable. According to our results, those with long‐standing vitiligo may be recommended to receive outpatient NB‐UVB phototherapy.

An update and review of narrowband ultraviolet B phototherapy for vitiligo

“…The findings of similar repigmentation efficacy, improvement in patient-reported quality of life, and higher rates of adverse events, were echoed in a recent systematic review of randomized control trials. 72 A prospective cohort study by Zhang et al 73 found that clinicbased NB-UVB generated better repigmentation rates compared to home-based NB-UVB after 3 months of treatment (p < 0.05), however, there was no significant difference in repigmentation rates between the two treatment modalities by 6 months of treatment:…”

“…A prospective cohort study by Zhang et al 73 found that clinic‐based NB‐UVB generated better repigmentation rates compared to home‐based NB‐UVB after 3 months of treatment ( p < 0.05), however, there was no significant difference in repigmentation rates between the two treatment modalities by 6 months of treatment: 84% of patients experienced repigmentation in the home‐based NB‐UVB group, compared with 90% in the clinic‐based NB‐UVB group. In addition, subgroup analysis in the same study revealed that long‐standing vitiligo cases had a significantly better response to clinic‐based NB‐UVB compared to home‐based NB‐UVB.…”

“…71,72 More studies with larger sample sizes are warranted to explore the benefits and risks of home-based phototherapy. Research is also needed to further investigate the recommendation by Zhang et al 73 to consider clinic-based NB-UVB rather than home-based NB-UVB for long-standing disease.…”

British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy 2022

“…This can be undertaken using either whole‐body units or handheld and non‐handheld devices for localized areas 33–36 . A prospective study showed no significant difference in repigmentation rates between home‐based and hospital‐based phototherapy, and only minimal adverse effects and similar health‐related quality‐of‐life scores 37 . A randomized controlled trial of home interventions (HI‐Light Vitiligo Trial) found that combination treatment with home‐based handheld NB‐UVB and potent topical corticosteroid was likely to be superior to potent topical corticosteroid monotherapy in the treatment of localized vitiligo 38 …”

“…[33][34][35][36] A prospective study showed no significant difference in repigmentation rates between home-based and hospital-based phototherapy, and only minimal adverse effects and similar health-related quality-of-life scores. 37 A randomized controlled trial of home interventions (HI-Light Vitiligo Trial) found that combination treatment with home-based handheld NB-UVB and potent topical corticosteroid was likely to be superior to potent topical corticosteroid monotherapy in the treatment of localized vitiligo. 38 It is important to recognize that there are increased safety concerns in the home setting that should be carefully considered.…”