Comparison of the efficacy and safety of 0.1% tacrolimus ointment and 0.1% mometasone furoate cream for adult vitiligo: A single-blinded pilot study

Silpa‐archa, Narumol; Nitayavardhana, Sunatra; Thanomkitti, Kanchalit; Chularojanamontri, Leena; Varothai, Supenya; Wongpraparut, Chanisada

doi:10.1016/j.dsi.2016.05.005

Cited by 8 publications

(27 citation statements)

References 12 publications

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“…Manual searching found one further article. Of these 19 RCTs matched the selection criteria . Reasons for excluding 58 papers are detailed in Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen RCTs, published between 2003 and 2018, involving 814 patients, were included; 385 were male (47.29%), with the mean age ranging from 8 to 48.8 years. Five studies were from Pakistan, three from Italy, and two from China.…”

Section: Resultsmentioning

confidence: 99%

“…Blinding of participants and personnel as well as blinding of outcome assessment showed high risk in 12 trials (Fig. ) . All studies, except three, had a low risk of bias with regard to selective reporting …”

Section: Resultsmentioning

confidence: 99%

“…1). [14][15][16][17][18][19][20][21]23,24,27,28 All studies, except three, had a low risk of bias with regard to selective reporting. 25,26,29 Quantitative meta-analyses…”

Section: Risk Of Bias Assessment Among Included Trialsmentioning

confidence: 99%

“…All interventions were well-tolerated; however, mild-to-moderate side effects such as burning sensation, erythema and pruritus were reported in 16 studies (Table 2). [14][15][16][19][20][21][23][24][25][26][27][28][29][30][31][32]…”

Section: Side Effects Among Included Trialsmentioning

confidence: 99%

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The efficacy and safety of tacrolimus as mono‐ and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials

Arora¹,

Rafiq

Shumack

et al. 2019

Aust J Dermatology

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There is currently no definitive treatment for vitiligo; various modalities include immune modulators phototherapy and skin camouflage. We investigated the efficacy and safety of topical tacrolimus either as monotherapy or combined therapy in the treatment of vitiligo. Electronic systematic search of the literature was carried out using four major databases. Randomised clinical trials (RCTs) that reported the use of topical tacrolimus in the treatment of human vitiligo have been included in a systematic review and meta‐analysis. Meta‐analysis was conducted via RevMan, and risk of bias was assessed through the Cochrane quality assessment tool. The protocol was published through PROSPERO (CRD42018112430). A total of 19 studies including 814 patients were included in our systematic review. The random‐effects‐model meta‐analysis of two studies revealed that the tacrolimus and narrowband ultraviolet B (NB‐UVB) combination therapy rates is better than NB‐UVB alone in inducing >75% repigmentation [RR 1.34 (95% CI: 01.05–1.71), P = 0.02]. Tacrolimus and steroids had similar potency in acheiving >75% repigmentation [RR 1.02 (95% CI: 0.19–5.51), P = 0.98]. Meta‐analysis of two studies revealed that the fractional laser and tacrolimus combination therapy is no better than tacrolimus alone in causing >75% repigmentation [RR 2.11 (95% CI: 0.87–5.09), P = 0.10]. Further investigating tacrolimus as mono‐ or adjuvant therapy for vitiligo is highly recommended. Combining tacrolimus to other treatment options such as steroids, phototherapy and laser may be superior to using tacrolimus alone.

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“…Manual searching found one further article. Of these 19 RCTs matched the selection criteria . Reasons for excluding 58 papers are detailed in Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…1). [14][15][16][17][18][19][20][21]23,24,27,28 All studies, except three, had a low risk of bias with regard to selective reporting. 25,26,29 Quantitative meta-analyses…”

Section: Risk Of Bias Assessment Among Included Trialsmentioning

confidence: 99%

Section: Side Effects Among Included Trialsmentioning

confidence: 99%

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The efficacy and safety of tacrolimus as mono‐ and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials

Arora¹,

Rafiq

Shumack

et al. 2019

Aust J Dermatology

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Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

et al. 2019

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IMPORTANCE Topical calcineurin inhibitors (TCIs), including tacrolimus and pimecrolimus, have been widely used for the treatment of vitiligo; however, the efficacy of TCI monotherapy is often underestimated. OBJECTIVES To estimate the treatment responses to both TCI monotherapy and TCI accompanied by phototherapy for vitiligo, based on relevant prospective studies, and to systematically review the mechanism of action of TCIs for vitiligo treatment. DATA SOURCES A comprehensive search of the MEDLINE, Embase, Web of Science and Cochrane Library databases from the date of database inception to August 6, 2018, was conducted. The main key words used were vitiligo, topical calcineurin inhibitor, tacrolimus, pimecrolimus, and FK506. STUDY SELECTION Of 250 studies initially identified, the full texts of 102 articles were assessed for eligibility. A total of 56 studies were identified: 11 studies on the TCI mechanism, 36 studies on TCI monotherapy, 12 studies on TCI plus phototherapy, and 1 study on TCI maintenance therapy. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data on study design, patients, intervention characteristics, and outcomes. Random-effects meta-analyses using the generic inverse variance weighting were performed for the TCI monotherapy and TCI plus phototherapy groups. MAIN OUTCOMES AND MEASURES The primary outcomes were the rates of at least mild (Ն25%), at least moderate (Ն50%), and marked (Ն75%) repigmentation responses to treatment. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed that study. RESULTS In the 56 studies included in the analysis, 46 (1499 patients) were selected to evaluate treatment response. For TCI monotherapy, an at least mild response was achieved in 55.0% (95% CI, 42.2%-67.8%) of 560 patients in 21 studies, an at least moderate response in 38.5% (95% CI, 28.2%-48.8%) of 619 patients in 23 studies, and a marked response in 18.1% (95% CI, 13.2%-23.1%) of 520 patients in 19 studies after median treatment duration of 3 months (range, 2-7 months). In the subgroup analyses, face and neck lesions showed an at least mild response in 73.1% (95% CI, 32.6-83.5%) of patients, and a marked response in 35.4% (95% CI, 24.9-46.0%) of patients. For TCI plus phototherapy, an at least mild response to TCI plus phototherapy was achieved in 89.5% (95% CI, 81.1-97.9%) of patients, and a marked response was achieved in 47.5% (95% CI, 30.6-64.4%) of patients. CONCLUSIONS AND RELEVANCE The use of TCIs, both as a monotherapy and in combination with phototherapy, should be encouraged in patients with vitiligo.

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Goals of Vitiligo Treatment, and Evidence‐Based Practice Guidelines for Medical and Surgical Management

Prier¹,

Pandya²

2018

Vitiligo

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Comparison of the efficacy and safety of 0.1% tacrolimus ointment and 0.1% mometasone furoate cream for adult vitiligo: A single-blinded pilot study

Cited by 8 publications

References 12 publications

The efficacy and safety of tacrolimus as mono‐ and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials

The efficacy and safety of tacrolimus as mono‐ and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

Goals of Vitiligo Treatment, and Evidence‐Based Practice Guidelines for Medical and Surgical Management

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