Vitiligo Maintenance Treatment with a Cream (Tacrolimus)

 
INTRODUCTION
Vitiligo affects around 1-2% of the world population.
Treatments include topicals (steroids, calcineurin inhibitors), phototherapy, lasers (excimer) and surgery (grafting).
When repigmentation is obtained, relapses are commonplace and affect around 40% of repigmented lesions.

METHODOLOGY
-74 consecutive patients with Vitiligo were assessed initially
-35 patients were included in the randomization as at least one lesion (1-4) was repigmented by more than 75% (41 did not meet the inclusion criteria). 19 were treated with tacrolimus 0.1% ointment for 24 weeks and 16 were treated with placebo.
-16 patients from each group were included in the Intention-to-Treat analysis (ITT). In one word ITT is a way of measuring a group of patients whether or not they undergo the final treatment-a beginning to end analysis (to read more: http://en.wikipedia.org/wiki/Intention- … t_analysis
 
RESULTS
-75% of lesions were located on the face.
-In two thirds of cases, repigmentation was obtained using topical tacrolimus
-In the intention-to-treat (ITT) analysis (n=72), 48.4% of lesions showed some depigmentation in the placebo group, whereas 26.8% did in the tacrolimus group (P=0.059)
-The treatment protocol analysis showed that 40% of lesions had some depigmentation in the placebo group, whereas only 9.7% did in the tacrolimus group (P=0.0075).
 
COMMENTS
–Twice weekly topical Tacrolimus 0.1% ointment (Protopic) application appears to be effective
-The best results maintenance of pigmentation appear to be with lesions located on the face and neck.
-According to the authors, the proposed regimen could also be applicable to topical steroids [medium strength such as mometosone furoate 0.1% (Elocon, Elomet, Elocom)]
-It is not clear whether the repigmentation was maintained with topical tacrolimus in patients who had initally obtained repigmentation with tacrolimus or with other methods (Topical steroids, phototherapy, excimer laser)