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Vitiligo: Targeted Therapies Add Color to Disease Pathophysiology

Khaled Ezzedine1, Terrence M Vance2, Iltefat H Hamzavi3

  • 1Department of Dermatology, Henri Mondor University Hospital, Créteil, France; EpidermE, Université Paris-Est Créteil, UPEC, Créteil, France.

The Journal of Investigative Dermatology
|July 26, 2020
PubMed

Insights

New clinical trials show that combining apremilast with narrowband ultraviolet B therapy did not improve repigmentation in nonsegmental vitiligo patients. This highlights the challenges in treating this skin condition.

Area of Science:

  • Dermatology
  • Immunology
  • Pharmacology

Background:

  • Vitiligo treatment has lacked FDA-approved drugs for decades, despite recent advancements.
  • Targeted therapies show promise for repigmentation, but clinical trial results vary.
  • Managing vitiligo remains challenging, even with combined therapeutic approaches.

Purpose of the Study:

  • To evaluate the efficacy of combining apremilast (a phosphodiesterase 4 inhibitor) with narrowband ultraviolet B (NB-UVB) therapy.
  • To compare this combination therapy against a placebo plus NB-UVB in patients with nonsegmental vitiligo.

Main Methods:

  • A randomized clinical trial was conducted.
  • Participants received either apremilast plus NB-UVB or placebo plus NB-UVB.
  • Patient outcomes were assessed for repigmentation of vitiligo lesions.

Main Results:

  • The combination of apremilast and NB-UVB did not yield significantly better repigmentation results compared to placebo and NB-UVB.
  • The trial reported negative results, indicating no added benefit from apremilast in this context.
  • This underscores the complexity of achieving successful vitiligo treatment.

Conclusions:

  • Combining apremilast with NB-UVB is not an effective strategy for repigmenting nonsegmental vitiligo.
  • Further research is needed to understand the underlying mechanisms of vitiligo and develop effective treatments.
  • Negative trial results are crucial for advancing the understanding and management of vitiligo.

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