The Effectiveness of Home-Based Phototherapy in Vitiligo: A Systematic Review and Meta-Analysis.

IF 2.2 4区 医学 Q2 DERMATOLOGY
Firdavis Xireaili, Hieu Ha, Zhao Feng Liu, Lawrence Lin, Michelle Min Hsiao, Adrian Mar, Christopher Chew
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引用次数: 0

Abstract

Background: Phototherapy with narrowband ultraviolet B (UVB) is an effective treatment for vitiligo. However, it requires frequent in-office visits. Self-administered home-based UVB (HBUVB) therapy with a handheld or panel device is an alternative that has received limited research attention. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness and safety of HBUVB in the treatment of vitiligo compared to in-office UVB (IOUVB).

Methods: Searches were conducted on Medline, Cochrane and Embase from inception until 4th of August, 2024. Studies with primary data of patients being treated with a hand-held UVB device were included in this study. Efficacy as measured in number of patients achieving > 50% or > 75% repigmentation was the primary study outcome. Secondary outcomes analyzed were cost, adverse events and adherence.

Results: Eighteen studies were included with a total of 1341 vitiligo patients. Of these, four studies (148 HBUVB and 143 IOUVB) could be used for the meta-analysis. HBUVB was not inferior to IOUVB at achieving > 50% (OR 1.04, 95% CI 0.58-1.87) and > 75% repigmentation (OR 1.26, 95% CI 0.65-2.42). Home-based UVB was not associated with an increase in risk for either erythema or burning sensations when compared to IOUVB. There was a 14% lower rate of discontinuation amongst patients using HBUVB.

Conclusions and significance/impact: Home-based UVB therapy is not inferior to in-office UVB therapy in efficacy or rate of adverse events and demonstrates favourable treatment adherence. This meta-analysis provides evidence supporting HBUVB as a safe and effective alternative to IOUVB in patients with vitiligo.

Trial registration: PROSPERO registration number: (CRD42023478123).

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家庭光疗治疗白癜风的有效性:一项系统综述和meta分析。
背景:窄带紫外线B光疗是治疗白癜风的有效方法。然而,它需要经常去办公室。使用手持式或面板式设备进行自我管理的基于家庭的UVB (HBUVB)治疗是一种替代方法,受到的研究关注有限。本系统综述和荟萃分析的目的是评价HBUVB治疗白癜风的有效性和安全性,并与室内UVB (IOUVB)进行比较。方法:在Medline、Cochrane和Embase上进行检索,检索时间自成立至2024年8月4日。本研究纳入了使用手持UVB装置治疗患者的研究。以达到> 50%或> 75%的患者数量衡量的疗效是主要的研究结果。次要结局分析为成本、不良事件和依从性。结果:纳入18项研究,共纳入1341例白癜风患者。其中,有4项研究(148项HBUVB和143项IOUVB)可用于meta分析。HBUVB在达到> 50% (OR 1.04, 95% CI 0.58-1.87)和> 75% (OR 1.26, 95% CI 0.65-2.42)方面并不亚于IOUVB。与IOUVB相比,家中的UVB与红斑或烧灼感的风险增加无关。在使用HBUVB的患者中,停药率降低14%。结论和意义/影响:家庭中波治疗在疗效和不良事件发生率上不逊于办公室中波治疗,并表现出良好的治疗依从性。本荟萃分析提供证据支持HBUVB作为白癜风患者IOUVB的安全有效替代。试验注册:普洛斯彼罗注册号:(CRD42023478123)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.40
自引率
7.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: The journal is a forum for new information about the direct and distant effects of electromagnetic radiation (ultraviolet, visible and infrared) mediated through skin. The divisions of the editorial board reflect areas of specific interest: aging, carcinogenesis, immunology, instrumentation and optics, lasers, photodynamic therapy, photosensitivity, pigmentation and therapy. Photodermatology, Photoimmunology & Photomedicine includes original articles, reviews, communications and editorials. Original articles may include the investigation of experimental or pathological processes in humans or animals in vivo or the investigation of radiation effects in cells or tissues in vitro. Methodology need have no limitation; rather, it should be appropriate to the question addressed.
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