Combination Therapy Best for Repigmentation in Vitiligo

Significantly superior and faster repigmentation with afamelanotide implant, narrowband UV-B

THURSDAY, Sept. 18, 2014 (HealthDay News) -- For patients with vitiligo, a combination of afamelanotide implant and narrowband ultraviolet B (NB-UV-B) phototherapy is superior to NB-UV-B monotherapy, according to a study published online Sept. 17 in JAMA Dermatology.

Henry W. Lim, M.D., from the Henry Ford Hospital in Detroit, and colleagues examined the efficacy and safety of combination therapy consisting of afamelanotide implant and NB-UV-B phototherapy for the treatment of generalized vitiligo. Men and women with a confirmed diagnosis of nonsegmental vitiligo that involved 15 to 50 percent of the total body surface were randomized to combination therapy (28 patients) or NB-UV-B monotherapy (27 patients).

The researchers found that at day 56, response in the combination therapy group was superior to that in the NB-UV-B monotherapy group (P < 0.05). A significantly higher percentage of patients in the combination therapy group achieved repigmentation, and at earlier times (face, 41.0 versus 61.0 days; P = 0.001; upper extremities, 46.0 versus 69.0 days; P = 0.003). Repigmentation was 48.64 and 33.26 percent in the combination therapy and NB-UV-B monotherapy groups, respectively. Patients with Fitzpatrick skin phototypes (SPT) IV to VI had significant improvement in the Vitiligo Area Scoring Index at days 56 and 84, while patients with SPT III had no significant difference.

"A combination of afamelanotide implant and NB-UV-B phototherapy resulted in clinically apparent, statistically significant superior and faster repigmentation compared with NB-UV-B monotherapy," the authors write.

One author disclosed financial ties to Clinuvel Pharmaceuticals, which funded the study and manufactures the afamelanotide implant.

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