Vitíligo. Tratamiento de 12 casos con tacrolimus tópico

Almeida, Pablo; Borrego, Leopoldo; Rodríguez-López, Julio; Luján, Dunia; Cameselle, D.; Hernández, Buenaventura

doi:10.1016/s0001-7310(05)73058-1

Cited by 8 publications

(11 citation statements)

References 13 publications

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“…7,25,32,35,41 Lesions on the face and neck showed an at least mild response in 73.1% (95% CI, 32.6%-83.5%) of 312 patients in 14 studies, 8,29,34,38,[45][46][47][48][49][50][52][53][54]64 and a marked response 35.4% (95% CI, 24.9%-7 46.0%) of 353 patients in 16 studies. 8,22,26,29,34,38,[45][46][47][48][49][50][51][52][53][54] Lesions on the trunk and extremities showed an at least mild response in 34.2% (95% CI, 13.9%-54.6% of 153 patients in 7 studies, 8,29,38,47,[52][53][54] and a marked response in 2.3% (95% 10 CI, 0.3%-4.3%) of 185 patients in 8 studies. 8,29,38,47,[52][53][54] Lesions on the hands and feet showed an at least mild response in 15.1% (95% CI, 6.7%-23.4%) in 48 patients in 3 studies, 29,47,…”

Section: Treatment Response To Tci Monotherapymentioning

confidence: 99%

“…8,29,38,47,[52][53][54] Lesions on the hands and feet showed an at least mild response in 15.1% (95% CI, 6.7%-23.4%) in 48 patients in 3 studies, 29,47,52 and no marked response was observed among 52 patients in 4 studies. 26,29,47,52 Treatment Response to TCI Plus Phototherapy Of the 12 studies in the TCI plus phototherapy group, 10 combined TCI treatment with NBVUB 30,36,56,[58][59][60][61][62][63]65 treatment with EL. 55,57 An at least mild response to TCI plus phototherapy was achieved in in 89.5% (95% CI, 81.1%-97.9%) of 433 patients in 8 studies, 30,[55][56][57][59][60][61][62] an at least moderate response was achieved in 72.9% (95% CI, 57.6%-88.2%) of 486 patients in 10 studies, 30,36,[55][56][57][58][59][60][61][62] and a marked response was achieved in 47.5% (95% CI, 30.6%-64.4%) of 490 patients in 9 studies.…”

Section: Treatment Response To Tci Monotherapymentioning

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. 7,8,22,[25][26][27]29,34,35,39,46,48 We pooled the total occurrences of common adverse events seen in TCI monotherapy. In 296 patients, the most common were a 7,8,22,[25][26][27]29,34,35,39,46,48 All of the events were transient and did not require additional treatment.…”

Section: Safety Of Tcimentioning

confidence: 99%

“…7,8,22,[25][26][27]29,34,35,39,46,48 We pooled the total occurrences of common adverse events seen in TCI monotherapy. In 296 patients, the most common were a 7,8,22,[25][26][27]29,34,35,39,46,48 All of the events were transient and did not require additional treatment. Other adverse events, including verruca, dysesthesia, and contact dermatitis, were rarely reported, and no studies reported adverse effects leading to discontinuation of treatment.…”

Section: Safety Of Tcimentioning

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: Treatment Response To Tci Monotherapymentioning

confidence: 99%

Section: Treatment Response To Tci Monotherapymentioning

confidence: 99%

Section: Safety Of Tcimentioning

confidence: 99%

Section: Safety Of Tcimentioning

confidence: 99%

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Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

et al. 2019

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“…Furthermore, vitiligo is considered an autoimmune disease (AID), as it can be associated with AIDs, including Hashimoto’s thyroiditis, diabetes mellitus, Addison’s disease, alopecia areata and ophthalmic abnormalities, such as iritis ( 4 , 6 – 8 ). This association is supported by: i) The presence of lymphocytes in the dermis of early lesions, ii) antibodies against melanocytes and antigens from the melanogenic system in a number of patients with active disease ( 9 , 10 ), and iii) the response to treatment with immunomodulatory agents, including corticosteroids and phototherapy ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 98%

Protein tyrosine phosphatase PTPN22 +1858C/T polymorphism is associated with active vitiligo

García-Meléndez

Salinas-Santander

Sánchez‐Domínguez

et al. 2014

Experimental and Therapeutic Medicine

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Vitiligo is characterized by a skin depigmentation disorder resulting from an autoimmune response targeting melanocytes. Within the genetic factors involved in the development of the vitiligo immune response, various genes in the major histocompatibility complex (MHC) and non-MHC loci have been considered to be risk factors. The PTPN22 gene encodes for a lymphoid protein tyrosine phosphatase, a regulator of the activation and development of T-cells. The +1858C/T polymorphism has been associated to autoimmune disease susceptibility in different populations and could be implicated in the onset of vitiligo. To assess the possible association between the presence of PTPN22 +1858C/T and vitiligo, 187 patients with vitiligo and 223 control subjects were analyzed in the study. Genomic DNA was isolated using the salting-out method and samples were subjected to polymerase chain reaction-restriction fragment length polymorphism in order to detect the PTPN22 +1858C/T polymorphism. Causal associations were determined by χ2 test and their respective odds ratio (OR) was assessed in a 2×2 contingency table. The results showed an association between active vitiligo and the allele T load [P=0.0418; OR, 2.5706; 95% confidence interval (CI), 1.0040–6.5816], and active vitiligo-CT genotype (P=0.0389, OR, 2.6548; 95% CI, 1.0191–6.9156). In conclusion, the present data indicates a possible association between the PTPN22 +1858C/T genotype and a significant susceptibility of developing an active form of vitiligo.

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Medical Therapies

Taı̈eb¹

2019

Vitiligo

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Vitíligo. Tratamiento de 12 casos con tacrolimus tópico

Cited by 8 publications

References 13 publications

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo

Protein tyrosine phosphatase PTPN22 +1858C/T polymorphism is associated with active vitiligo

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