Excimer 308-Nm Light in the Combination Treatment of Vitiligo: A Systematic Review and Network Meta-Analysis

Excimer 308-nm light is often used for vitiligo treatment in combination with adjuvants. We aimed to evaluate the efficacy of these combination therapies. We searched MEDLINE, Embase and the Cochrane Library from inception to November 2024. All randomised trials reporting efficacy outcomes for vitiligo patients treated with excimer 308-nm light were included. Primary outcomes were achieving ≥ 50%, ≥ 75% and 100% skin repigmentation. Pairwise comparisons of treatment repigmentation were summarised as risk ratios (RRs) with 95% confidence intervals (CIs) and a frequentist, random-effects network meta-analysis with a graph-theoretical approach was used to generate summary estimates. Thirty-eight studies involving 1841 participants were included. Excimer 308-nm light with topical calcineurin inhibitors or topical corticosteroids significantly improved repigmentation outcomes compared to excimer monotherapy with ≥ 50% (RR 1.47, 95% CI 1.19-1.81; RR 1.65, 95% CI 1.32-2.06) and ≥ 100% repigmentation (RR 1.60, 95% CI 1.03-2.49; RR 2.31, 95% CI 1.50-3.56) respectively. Excimer in combination with topical antioxidants (RR 43.00, 95% CI 2.68-688.68), intramuscular corticosteroid (RR 1.76, 95% CI 1.13-2.74) and platelet rich plasma (RR 1.76, 95% CI 1.32-2.35) enhanced ≥ 50% repigmentation. These findings highlight the value of combination therapy with excimer light as a useful option in the management of vitiligo.