Hi-Light Vitiligo
Trial question
Is combination treatment with narrowband UV-B light plus topical corticosteroids superior to topical corticosteroids alone in patients with vitiligo?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
48.0% female
52.0% male
N = 348
348 patients (168 female, 180 male).
Inclusion criteria: adult and pediatric patients with active vitiligo affecting < 10% of skin.
Key exclusion criteria: segmental or universal vitiligo; vitiligo limited to areas contraindicated for treatment with potent topical corticosteroid or evidence of marked Koebner phenomenon; history of skin cancer; radiotherapy use or photosensitivity; pregnancy.
Interventions
N=175 combination therapy (topical corticosteroid ointment plus narrowband UV-B light).
N=173 topical corticosteroid (topical corticosteroid plus dummy narrowband UV-B light).
Primary outcome
Target patch treatment success at 9 months
27%
17%
27.0 %
20.3 %
13.5 %
6.8 %
0.0 %
Combination
therapy
Topical
corticosteroid
Significant
increase ▲
NNT = 10
Significant increase in target patch treatment success at 9 months (27% vs. 17%; OR 1.93, 95% CI 1.02 to 3.68).
Secondary outcomes
Significant increase in treatment success as assessed by blinded patient and public involvement assessors at 9 months (28% vs. 11%; OR 3.52, 95% CI 1.8 to 6.89).
Significant increase in repigmentation as assessed by blinded dermatologist using digital images of target patch at 9 months (15% vs. 3%; OR 4.62, 95% CI 1.5 to 14.2).
Conclusion
In adult and pediatric patients with active vitiligo affecting < 10% of skin, combination therapy was superior to topical corticosteroid with respect to target patch treatment success at 9 months.
Reference
K S Thomas, J M Batchelor, P Akram et al. Randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo: results of the HI-Light Vitiligo Trial. Br J Dermatol. 2021 May;184(5):828-839.
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