Efficacy of NB-UVB and azathioprine combination in the therapy of nonsegmental vitiligo

Abstract

BACKGROUND: Vitiligo is a multifactorial acquired disease characterized by the appearance of depigmented, clearly delineated patches, on various areas on the skin. Narrowband Ultraviolet B Therapy is a first-line therapy for nonsegmental vitiligo. At the same time, it often takes at least 6 months to achieve optimal results, which is not always convenient for patients, brings additional financial costs of treatment. Therefore, in most cases to reduce the number of phototherapy sessions requires the use of additional drugs aimed at stopping the progression of the process and with a minimal spectrum of side effects.
 AIM: to compare the effectiveness of azathioprine in combination with NB-UVB and NB-UVB monotherapy in progressive non-segmental vitiligo.
 MATERIALS AND METHODS: The study included 60 patients with advanced non-segmental vitiligodivided into two groups of 30 people in each. Group A patients received therapy with azathioprine in combination with NB-UVB, and Group B patients ― NB-UVB monotherapy. VASI (Vitiligo Area Scoring Index) and DLQI (Dermatology Life Quality Index) were used for all patients to evaluate therapy efficacy.
 RESULTS: All 60 patients diagnosed with nonsegmental progressive vitiligo completed the study and were included in the final analysis. Among patients who received the combined therapy protocol of azathioprine combined with narrowband phototherapy, a statistically more significant reduction in the severity and prevalence of the skin process was noted compared to the group of patients who received NB-UVB alone. More significant arresting of disease progression was noticed: in group A, among 30 patients, only 4 patients developed new lesions of vitiligo within 6 months of therapy, and in group B ― in 11 out of 30 patients. Group A patients showed a more significant reduction of VASI and DLQI compared to the control group.
 CONCLUSION: Thus, the combination of NB-UVB and azathioprine in the treatment of non-segmental vitiligo showed great efficacy in arresting and reducing of the disease activity, prevalence and severity of vitiligo. Azathioprine is well tolerated by patients and has a low spectrum of side effects, which allows its successful use to stabilize vitiligo and stimulate repigmentation of foci.