Comparison of various excimer laser (EL) combination therapies for vitiligo: a systematic review and network meta-analysis

Abstract

Aim

This study aimed to compare the efficacy and safety of excimer laser (EL)-based combination regimens in improving repigmentation.

Methods

A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, and Embase on July 1, 2023, to include randomized controlled trials of EL combination treatments for vitiligo that met the criteria. The primary outcome measure was a repigmentation rate ≥ 75%, and the secondary outcome measures were a repigmentation rate of ≤ 25% and adverse events.

Results

Eleven studies involving 348 patients were included. Network Meta-Analysis showed that EL combined with antioxidants (SUCRA = 98.8%), EL combined with calcipotriol (SUCRA = 59.8%) and EL combined with tacalcitol (SUCRA = 59.6%) were the three optimal interventions achieving repigmentation rates ≥ 75%. EL alone (SUCRA = 77.6%), EL combined with tacalcitol (SUCRA = 61.7%) and EL combined with antioxidants (SUCRA = 57.2%) were the three interventions with the highest rates of treatment failure. Adverse events in all groups mainly included erythema, burning sensation and hyperpigmentation. Based on the results of the current study, EL combination therapies were safe with mild adverse events.

Conclusion

EL combined with antioxidants was the preferred regimen for vitiligo, whereas EL alone was the regimen with the highest rate of treatment failure in vitiligo.

Keywords:

• Excimer laser
• vitiligo
• net meta-analysis
• antioxidant
• repigmentation rate

Author contributions

ChanXiu Li: design, data collection and analysis, mapping, drafting; Yue Hu: design, data collection, mapping; ZengYi Mu: design, data collection, mapping; Lei Shi: design, data analysis, content modification; Xiao Sun: design, data collection, content modification; XinYue Wang: design, data collection, data interpretation; YaPing Wang: design, data collection; XinHong Li: design, manuscript revision, data interpretation, final approval.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

National TCM Outstanding Talents Funding Program of the State Administration of Traditional Chinese Medicine (Letter [2022] No. 1 of the State Administration of Traditional Chinese Medicine): Training Program for Clinical Outstanding Talents in TCM