The Effectiveness of Home-Based Phototherapy in Vitiligo: A Systematic Review and Meta-Analysis

Phototherapy with narrowband ultraviolet B (UVB) is an effective treatment for vitiligo. However, it requires frequent in-office visits. Self-administered home-based UVB (HBUVB) therapy with a handheld or panel device is an alternative that has received limited research attention. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness and safety of HBUVB in the treatment of vitiligo compared to in-office UVB (IOUVB).

Searches were conducted on Medline, Cochrane and Embase from inception until 4th of August, 2024. Studies with primary data of patients being treated with a hand-held UVB device were included in this study. Efficacy as measured in number of patients achieving > 50% or > 75% repigmentation was the primary study outcome. Secondary outcomes analyzed were cost, adverse events and adherence.

Eighteen studies were included with a total of 1341 vitiligo patients. Of these, four studies (148 HBUVB and 143 IOUVB) could be used for the meta-analysis. HBUVB was not inferior to IOUVB at achieving > 50% (OR 1.04, 95% CI 0.58-1.87) and > 75% repigmentation (OR 1.26, 95% CI 0.65-2.42). Home-based UVB was not associated with an increase in risk for either erythema or burning sensations when compared to IOUVB. There was a 14% lower rate of discontinuation amongst patients using HBUVB.

Home-based UVB therapy is not inferior to in-office UVB therapy in efficacy or rate of adverse events and demonstrates favourable treatment adherence. This meta-analysis provides evidence supporting HBUVB as a safe and effective alternative to IOUVB in patients with vitiligo.

PROSPERO registration number: (CRD42023478123).