Segmental vitiligo: A randomized controlled trial to evaluate efficacy and safety of 0.1% tacrolimus ointment vs 0.05% fluticasone propionate cream

Kathuria, Sushruta; Khaitan, Binod K.; Ramam, M; Sharma, Vinod

doi:10.4103/0378-6323.90949

Cited by 29 publications

(7 citation statements)

References 14 publications

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“…We analyzed 46 studies involving 1499 patients to evaluate treatment response to TCI therapy (Table 2); 36 studies with 941 patients were included in the TCI monotherapy group and 12 studies with 558 patients were in the TCI plus phototherapy group . The median duration of treatment was 3 months (range, 2-7 months).…”

Section: Resultsmentioning

confidence: 99%

“…The median duration of treatment was 3 months (range, 2-7 months). An at least mild response (≥25% repigmentation) to TCI monotherapy was achieved in 55.0% (95% CI, 42.2%-67.8%) of 560 patients in 21 studies (Figure 2) (Table 3) (eFigure in the Supplement), an at least moderate response (≥50% repigmentation) was achieved in 38.5% (95% CI, 28.2%-48.8%) of 619 patients in 23 studies, and a marked response (≥75% repigmentation) was achieved in 18.1% (95% CI, 13.2%-23.1%) of 520 patients in 19 studies . In children, an at least mild response to TCI monotherapy was achieved in 66.4% (95% CI, 43.2%-89.7%) of 162 patients in 5 studies, and a marked response to TCI monotherapy was achieved in 31.7% of patients (31.7%; 95% CI, 6.7%-56.8%) in 5 studies …”

Section: Resultsmentioning

confidence: 99%

“…Of the 36 clinical studies of TCI monotherapy included in this analysis, 25 referred to adverse events and 12 reported the number of occurrences of each adverse event . We pooled the total occurrences of common adverse events seen in TCI monotherapy.…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

et al. 2019

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“…Khalid applied 0.05% clobetasol propionate to treat 23 patients, there were mild atrophy in four cases, telangiectasia in two case, and acneiform papules in two participants [5]. There is mounting evidence showed that atrophy,telangiectasia, hypertrichosis, and acneiform eruptions may develop when topical corticosteroids were used, and this side effect hampers their use, especially when the face is involved [67891011]. In this circumstance, topical CIs provide a favorable alternative.…”

Section: Introductionmentioning

confidence: 99%

Pimecrolimus increases the melanogenesis and migration of melanocytes in vitro

Chen

Tan

et al. 2017

Korean J Physiol Pharmacol

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Vitiligo is an intriguing depigmentary disorder and is notoriously difficult to be treated. The ultimate goal of vitiligo treatment is to replenish the lost melanocytes by immigration from hair follicle and to restore the normal function of melanogenesis by residual melanocytes. There are two types of topical calcineurin inhibitors called tacrolimus and pimecrolimus, and are recommended as the first-line treatments in vitiligo. Although pimecrolimus is efficacious for the repigmentation of vitiligo, its intrinsic mechanisms have never been investigated in vitro. This research aimed to study the ability of pimecrolimus on stimulating melanogenesis, melanocyte migration and MITF (microphthalmia associated transcription factor) protein expression. Results showed that pimecrolimus at the dosages of 1, 10, 102 nM were neither mitogenic nor cytotoxic to melanocytes. The addition of pimecrolimus at 10, 102 and 103 nM significantly increased intracellular tyrosinase activity, which was consistent with the elevated content of melanin content at the same concentrations. The peak effect was seen at 72 h in response to 102 nM pimecrolimus. Results of the wound scratch assay and Transwell assays indicate that pimecrolimus is effective in facilitating melanocyte migration on a collagen IV-coated surface. In addition, MITF protein yield reached the highest by pimecrolimus at 102 nM. In brief, pimecrolimus enhances melanin synthesis as well as promotes migration of melanocytes directly, possibly via their effects on MITF protein expression.

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“…Клинически эффективно и безопасно было применение такролимуса в терапии проявлений красного плоского лишая на коже и слизистых оболочках, витилиго, как альтернативный вариант терапии стойкой кожной формы эритематоза, очаговой алопеции, розацеа, лимфомы кожи и саркоидоза, других дерматозов [39][40][41][42][43][44][45][46].…”

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Tacrolimus in pathogenetic therapy of chronic dermatoses

Филимонкова¹,

Колбина²

2018

Klin. dermatol. venerol.

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Приведены данные зарубежных и отечественных клинических исследований по изучению эффективности и безопасности топических ингибиторов кальциневрина (ТИК) в лечении атопического дерматита и других хронических дерматозов. Представлены основные механизмы действия ТИК и преимущества препарата группы ТИК такролимуса. Такропик (0,1 и 0,03% мазь такролимуса)-топическое средство для лечения атопического дерматита средней и тяжелой степени у взрослых и детей. Ключевые слова: топические ингибиторы кальциневрина, такролимус, атопический дерматит, топическая терапия хронических дерматозов, клинические исследования, Такропик.

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Segmental vitiligo: A randomized controlled trial to evaluate efficacy and safety of 0.1% tacrolimus ointment vs 0.05% fluticasone propionate cream

Abstract: Both tacrolimus and fluticasone propionate produce variable but overall unsatisfactory repigmentation in segmental vitiligo.

Cited by 29 publications

References 14 publications

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

Pimecrolimus increases the melanogenesis and migration of melanocytes in vitro

Tacrolimus in pathogenetic therapy of chronic dermatoses

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