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Oral mini-pulse therapy in vitiligo: a systematic review
Sonia Chavez-Alvarez1, Maira Herz-Ruelas1, Ana Karina Raygoza-Cortez2
1Dermatology Department, Hospital Universitario "Dr. José Eleuterio González" UANL, Monterrey, Nuevo León, México.
International Journal of Dermatology
|March 17, 2021
Summary
Oral mini-pulse (OMP) therapy showed no additional benefit for nonsegmental vitiligo compared to other treatments. High-quality clinical trials are needed to further evaluate its effectiveness and safety in vitiligo management.
Area of Science:
- Dermatology
- Clinical Research
- Evidence-Based Medicine
Background:
- Limited evidence exists for alternative treatments in nonstable vitiligo.
- Nonsegmental vitiligo management requires further investigation of therapeutic options.
Purpose of the Study:
- To review the efficacy and safety of oral mini-pulse (OMP) therapy for nonsegmental vitiligo.
- To assess the available evidence on OMP therapy in vitiligo treatment.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) comparing OMP therapy with active treatments or placebo.
- Searched databases: Scopus, Web of Science, MEDLINE, Embase (inception to May 2020).
- Assessed risk of bias using Cochrane's tool and evidence quality with GRADE.
Main Results:
- Four Indian RCTs involving 246 patients were included.
- OMP therapy (betamethasone/dexamethasone) for 6 months showed up to 32% repigmentation (>75%) as monotherapy.
- No significant difference in disease arrest compared to other treatments; weight gain was a common adverse effect. High overall risk of bias was noted.
Conclusions:
- OMP therapy offers no additional therapeutic value over existing treatments for nonsegmental vitiligo.
- High-quality clinical trials are urgently required to definitively evaluate OMP therapy's role.
