Predictive Model for Response Rate to Narrowband Ultraviolet B Phototherapy in Vitiligo: A Retrospective Cohort Study of 579 Patients

Abstract

Vitiligo is an acquired depigmenting disorder. To date, there is no predictive model for its response rate to narrowband ultraviolet B (NBUVB) phototherapy. The aim of this study was to investigate the different types of response of patients with non-segmental vitiligo undergoing NBUVB 3 times a week. Many patients who were previously considered non-responders were given the opportunity to continue the treatment. Long-term maintenance of treatment and follow-up of a cohort of 579 patients enabled different subtypes of response (very rapid, rapid, average, slow and "non-responders") to be described for the first time, and a predictive model of response to be constructed based on repigmentation rate in the first 48 sessions of NBUVB. Among those patients who did not respond during the first 48 sessions, a new subgroup of patients was found, termed "very-slow" responders, who achieved a low, but significant, level of repigmentation after 96 sessions of NBUVB.

Evaluation of Long Term Prognosis in Patients Treated with Narrowband Ultraviolet B: A Retrospective Study for 8 Years

“…Better response was found in the face, neck, trunk and superior limbs. 16 In our study 5 of 11 vitiligo patients improved more than 75% (complete remission). Small sample size of vitiligo group in our study, prevent us to evaluate the repigmentation rate according to number of sessions.…”

“…In a 579 vitiligo patient-cohort study, a predictive model of response was described for the first time based on repigmentation rate in the first 48 sessions (very rapid, rapid, average, slow responders, non-responders). 16 It is reported that; 67 patients improved more than 75%, 335 between 25-75% and 177 less than 25% after NB-UVB therapy. Better response was found in the face, neck, trunk and superior limbs.…”

Precision medicine and personalized approach in vitiligo

“…These patients did not achieve significant improvement after 48 sessions, but demonstrated >30% repigmentation between 48 and 96 sessions. Thus, the duration of NB‐UVB phototherapy needs to be tailored as per treatment response and upto 96 sessions may be required before labeling patients as nonresponders 44 …”

What is new in narrow-band ultraviolet-B therapy for vitiligo?

“…In a retrospective cohort study of 579 patients, Cabrera et al attempted to develop a predictive model for response rate of nonsegmental vitiligo to NB-UVB phototherapy. [34] Treatment was continued for many patients who were previously considered nonresponders. Response rates were classified as very rapid, rapid, average, slow, and nonresponders.…”

“…Response rates were classified as very rapid, rapid, average, slow, and nonresponders. [34] The authors reported a new subgroup among the nonresponders as those who failed to respond in the first 48 sessions, but showed significant repigmentation after 96 sessions of NB-UVB. They termed this subgroup as “very slow responders.” According to the observations of VWG committee members, a slower than usual response could be seen in some patients, thus a minimum of 72 NB-UVB sessions should be administered before labeling a patient as a nonresponder.…”