Combination therapy outpaces monotherapy in vitiligo trial

A new study suggests the combination therapy of afamelanotide implant and narrowband ultraviolet B (NB-UVB) phototherapy is more effective than NB-UVB therapy alone in treating vitiligo.

A research team led by Henry W. Lim, M.D., of the Henry Ford Hospital in Detroit, enrolled 55 men and women ages 18 or older who had been diagnosed with nonsegmental vitiligo over 15 to 50 percent of their body. Twenty-eight patients were randomized to combination therapy and 27 patients to NB-UVB monotherapy.

The researchers found that by day 56, a significantly higher percentage of patients in the combination therapy group had achieved repigmentation (48.67 versus 33.26 percent for the monotherapy group) and that they did it in less time (41 versus 61 days for the face, 46 versus 69 days for the upper extremities). According to the study, patients with Fitzpatrick skin phototypes IV to VI had significant improvement in the Vitiligo Area Scoring Index at days 56 and 84, while there was no significant difference in patients with Fitzpatrick skin phototype III.

Dr. Lim tells Dermatology Times that for dermatologists and their patients, the study’s most important finding is that “the combination treatment resulted in accelerated rate of repigmentation in vitiligo.”

The study was published online Sept. 17 in JAMA Dermatology. One author disclosed financial ties to Clinuvel Pharmaceuticals, which funded the study and manufactures the afamelanotide implant.