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The efficacy of ablation-based combination therapy for vitiligo: A systematic review and meta-analysis
Yih-An King1, Tsung-Yu Tsai2, Hsiou-Hsin Tsai1
1Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan.
Background And Objectives:
This study aimed to compare the efficacy of vitiligo treatments with and without ablation therapy.
Patients And Methods:
We conducted a systematic review and meta-analysis of literature published before September 15, 2017. Comparative studies of vitiligo patients treated with and without ablation therapy were included. The primary outcome was ≥ 50 % repigmentation. Secondary outcomes were ≥ 75 % repigmentation and patient scores on a subjective visual analogue scale.
Results:
Fifteen studies with a total of 401 participants were included. The ablation-based combination therapy group had significantly superior results to the control group (odds ratio [OR] for ≥ 50 % repigmentation: 10.490, 95 % confidence interval [CI]: 4.632-23.757; OR for ≥ 75 % repigmentation: 5.812, 95 % CI: 2.194-15.393). Patients receiving ablation-based combination therapy were significantly more satisfied with the efficacy than the control group (standardized mean difference: 1.073, 95 % CI: 0.528-1.619). Subgroup analysis showed that the erbium laser group, CO2 laser group and fractional CO2 laser group achieved significantly better repigmentation than the control groups.
Conclusions:
According to objective and subjective evaluations, treatments for vitiligo are more effective when combined with ablation therapy than when used alone.
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