Efficacy of NB-UVB and azathioprine combination in the therapy of nonsegmental vitiligo

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅存取

详细

BACKGROUND: Vitiligo is a multifactorial acquired disease characterized by the appearance of depigmented, clearly delineated patches, on various areas on the skin. Narrowband Ultraviolet B Therapy is a first-line therapy for nonsegmental vitiligo. At the same time, it often takes at least 6 months to achieve optimal results, which is not always convenient for patients, brings additional financial costs of treatment. Therefore, in most cases to reduce the number of phototherapy sessions requires the use of additional drugs aimed at stopping the progression of the process and with a minimal spectrum of side effects.

AIM: to compare the effectiveness of azathioprine in combination with NB-UVB and NB-UVB monotherapy in progressive non-segmental vitiligo.

MATERIALS AND METHODS: The study included 60 patients with advanced non-segmental vitiligodivided into two groups of 30 people in each. Group A patients received therapy with azathioprine in combination with NB-UVB, and Group B patients ― NB-UVB monotherapy. VASI (Vitiligo Area Scoring Index) and DLQI (Dermatology Life Quality Index) were used for all patients to evaluate therapy efficacy.

RESULTS: All 60 patients diagnosed with nonsegmental progressive vitiligo completed the study and were included in the final analysis. Among patients who received the combined therapy protocol of azathioprine combined with narrowband phototherapy, a statistically more significant reduction in the severity and prevalence of the skin process was noted compared to the group of patients who received NB-UVB alone. More significant arresting of disease progression was noticed: in group A, among 30 patients, only 4 patients developed new lesions of vitiligo within 6 months of therapy, and in group B ― in 11 out of 30 patients. Group A patients showed a more significant reduction of VASI and DLQI compared to the control group.

CONCLUSION: Thus, the combination of NB-UVB and azathioprine in the treatment of non-segmental vitiligo showed great efficacy in arresting and reducing of the disease activity, prevalence and severity of vitiligo. Azathioprine is well tolerated by patients and has a low spectrum of side effects, which allows its successful use to stabilize vitiligo and stimulate repigmentation of foci.

作者简介

Kseniia Vovdenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

编辑信件的主要联系方式.
Email: Vovdenkoksenia@ya.ru
ORCID iD: 0000-0003-1415-3940
SPIN 代码: 8315-2175

Graduate Student

俄罗斯联邦, Moscow

Ainur Khafizova

Lomonosov Moscow State University

Email: aya.khafizova@gmail.com
ORCID iD: 0000-0003-4764-6792
SPIN 代码: 8282-5488

Cand. Sci. (Biol.)

俄罗斯联邦, Moscow

Konstantin Lomonosov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: lamclinic@yandex.ru
ORCID iD: 0000-0002-4580-6193
SPIN 代码: 4784-9730

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

参考

  1. Ezzedine K, Eleftheriadou V, Whitton M, van Geel N. Vitiligo. Lancet. 2015;386(9988):74–84. doi: 10.1016/S0140-6736(14)60763-7
  2. Ezzedine K, Grimes PE, Meurant JM, et al. Living with vitiligo: results from a national survey indicate differences between skin phototypes. Br J Dermatol. 2015;173(2):607–609. doi: 10.1111/bjd.13839
  3. Simons RE, Zevy DL, Jafferany M. Psychodermatology of vitiligo: psychological impact and consequences. Dermatol Ther. 2020;33(3):e13418. doi: 10.1111/dth.13418
  4. Sarkar S, Sarkar T, Sarkar A, et al. Vitiligo and psychiatric morbidity: a profile from a vitiligo clinic of a rural-based tertiary care center of Eastern India. Indian J Dermatol. 2018;63(4):281–284. doi: 10.4103/ijd.IJD_142_18
  5. Sangma LN, Nath J, Bhagabati D. Quality of life and psychological morbidity in vitiligo patients: a study in a teaching hospital from north-East India. Indian J Dermatol. 2015;60(2):142–146. doi: 10.4103/0019-5154.152508
  6. Taieb A, Alomar A, Böhm M, et al. Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol. 2013;168(1):5–19. doi: 10.1111/j.1365-2133.2012.11197.x
  7. Chavez-Alvarez S, Herz-Ruelas M, Villarreal-Martinez A, et al. Azathioprine: its uses in dermatology. An Bras Dermatol. 2020;95(6):731–736. doi: 10.1016/j.abd.2020.05.003
  8. Okovity SV. Clinical pharmacology of immunosuppressants. Rev Clin Pharmacol Drug Therapy. 2003;2(2):2–34. (In Russ).
  9. Kubelis-López DE, Zapata-Salazar NA, Said-Fernández SL, et al. Updates and new medical treatments for vitiligo (Review). Exp Ther Med. 2021;22(2):797. doi: 10.3892/etm.2021.10229
  10. Norris DA, Kissinger RM, Naughton GM, et al. Evidence for immunologic mechanisms in human vitiligo: patients’ sera induce damage to human melanocytes in vitro by complement-mediated damage and antibody-dependent cellular cytotoxicity. J Invest Dermatol. 1988;90(6):783–789. doi: 10.1111/1523-1747.ep12461505
  11. Iannella G, Greco A, Didona D, et al. Vitiligo: Pathogenesis, clinical variants and treatment approaches. Autoimmun Rev. 2016;15(4):335–343. doi: 10.1016/j.autrev.2015.12.006
  12. Olisova OY, Andreeva EV. Once more about hyperpigmentation. Russ J Skin Venereal Diseases. 2014;17(2):20–24. (In Russ). doi: 10.17816/dv36849
  13. Anbar TS, Hegazy RA, Picardo M, et al. Beyond vitiligo guidelines: combined stratified/personalized approaches for the vitiligo patient. Exp Dermatol. 2014;23(4):219–223. doi: 10.1111/exd.12344
  14. Whitton ME, Pinart M, Batchelor J, et al. Interventions for vitiligo. Cochrane Database Syst Rev. 2015;(2):CD003263. doi: 10.1002/14651858.CD003263.pub5
  15. Olisova OY. Teplyuk NP, Pinegin VB. Modern methodes of psoriasis treatment. Russ J Med. 2015;23(9):483–486. (In Russ).
  16. Bae JM, Jung HM, Hong BY, et al. Phototherapy for vitiligo: a systematic review and meta-analysis. JAMA Dermatol. 2017;153(7):666–674. doi: 10.1001/jamadermatol.2017.0002
  17. Radmanesh M, Saedi K. The efficacy of combined PUVA and low-dose azathioprine for early and enhanced repigmentation in vitiligo patients. J Dermatolog Treat. 2006;17(3):151–153. doi: 10.1080/09546630600791442
  18. Madarkar M, Ankad B, Manjula R. Comparative study of safety and efficacy of oral betamethasone pulse therapy and azathioprine in vitiligo. Clin Dermatology Rev. 2019;3(2):121–125. doi: 10.4103/CDR.CDR_13_18

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. The evolution of the vitiligo area scoring index (VASI; a) and the Dermatology Life Quality Index (ДИКЖ; b) during the entire study period (24 weeks).

下载 (192KB)
索引源数据
3. Fig. 2. Photos of patients before and after treatment with a combination of azathioprine and UVB-311 m.

下载 (494KB)
索引源数据

版权所有 © Eco-Vector, 2022


 


##common.cookie##