Efficacy and Safety of Tacrolimus 0.1% for the Treatment of Facial Vitiligo: A Multicenter Randomized, Double-Blinded, Vehicle-Controlled Study.


Journal

The Journal of investigative dermatology
ISSN: 1523-1747
Titre abrégé: J Invest Dermatol
Pays: United States
ID NLM: 0426720

Informations de publication

Date de publication:
07 2021
Historique:
received: 11 11 2020
revised: 15 12 2020
accepted: 20 12 2020
pubmed: 8 2 2021
medline: 24 11 2021
entrez: 7 2 2021
Statut: ppublish

Résumé

Topical calcineurin inhibitors are used off label in the treatment of vitiligo, and there is a lack of placebo-controlled, blinded studies to support their use. This study aimed to compare the efficacy of tacrolimus 0.1% ointment with that of the vehicle for repigmentation in adult patients with facial vitiligo. This study was a 24-week multicenter randomized parallel double-blind study with a 24-week post-treatment follow-up extension. Participants included were adult patients with recent facial vitiligo target lesions (<2 years) without changes in pigmentation or size over the previous 3 months. Patients received either tacrolimus 0.1% ointment or vehicle twice daily. The primary outcome was a therapeutic success, defined as a change ≥75% in the repigmentation of the target lesion between baseline and week 24, measured by ImageJ software. Secondary outcome measures were a variation of the physicians' global assessment scores and patients' satisfaction scores, safety data, and the rate of relapse at week 48. A total of 42 patients were included. Therapeutic success was achieved in 65% of tacrolimus-treated patients versus 0% of vehicle-treated patients at week 24 (P < 0.0001). Only 40% of relapse was observed at 48 weeks. Twice-daily tacrolimus 0.1% ointment showed superior efficacy to that of the vehicle through the 24 weeks of intervention and 24 weeks of follow-up in adult patients with facial vitiligo. This study was registered at ClinicalTrials.gov (identifier: NCT02466997).

Sections du résumé

BACKGROUND
Topical calcineurin inhibitors are used off label in the treatment of vitiligo, and there is a lack of placebo-controlled, blinded studies to support their use.
OBJECTIVE
This study aimed to compare the efficacy of tacrolimus 0.1% ointment with that of the vehicle for repigmentation in adult patients with facial vitiligo.
DESIGN
This study was a 24-week multicenter randomized parallel double-blind study with a 24-week post-treatment follow-up extension.
POPULATION
Participants included were adult patients with recent facial vitiligo target lesions (<2 years) without changes in pigmentation or size over the previous 3 months.
INTERVENTION
Patients received either tacrolimus 0.1% ointment or vehicle twice daily.
MAIN OUTCOMES AND MEASURES
The primary outcome was a therapeutic success, defined as a change ≥75% in the repigmentation of the target lesion between baseline and week 24, measured by ImageJ software. Secondary outcome measures were a variation of the physicians' global assessment scores and patients' satisfaction scores, safety data, and the rate of relapse at week 48.
RESULTS
A total of 42 patients were included. Therapeutic success was achieved in 65% of tacrolimus-treated patients versus 0% of vehicle-treated patients at week 24 (P < 0.0001). Only 40% of relapse was observed at 48 weeks.
CONCLUSIONS AND RELEVANCE
Twice-daily tacrolimus 0.1% ointment showed superior efficacy to that of the vehicle through the 24 weeks of intervention and 24 weeks of follow-up in adult patients with facial vitiligo.
TRIAL REGISTRATION
This study was registered at ClinicalTrials.gov (identifier: NCT02466997).

Identifiants

pubmed: 33549606
pii: S0022-202X(21)00077-4
doi: 10.1016/j.jid.2020.12.028
pii:
doi:

Substances chimiques

Calcineurin Inhibitors 0
Ointments 0
Tacrolimus WM0HAQ4WNM

Banques de données

ClinicalTrials.gov
['NCT02466997']

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1728-1734

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Julien Seneschal (J)

Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin disorders, Hôpital Saint-André, Bordeaux, France; INSERM U1035, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers (BMGIC), Université de Bordeaux, Bordeaux, France.

Alexandra Duplaine (A)

Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin disorders, Hôpital Saint-André, Bordeaux, France.

Hervé Maillard (H)

Department of Dermatology, Centre Hospitalier - Le Mans, Le Mans, France.

Thierry Passeron (T)

Department of Dermatology, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.

Nicolas Andreu (N)

Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin disorders, Hôpital Saint-André, Bordeaux, France.

Régis Lassalle (R)

Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, Bordeaux, France.

Clélia Favary (C)

Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, Bordeaux, France.

Catherine Droitcourt (C)

Department of Dermatology, CHU de Rennes, Rennes, France.

Alain Taïeb (A)

Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin disorders, Hôpital Saint-André, Bordeaux, France.

Khaled Ezzedine (K)

Department of Dermatology, Henri Mondor University Hospital, Créteil, France; Epidemiology in Dermatology and Evaluation of Therapeutics (EpidermE), Université Paris-Est Créteil Val de Marne (UPEC), Créteil, France. Electronic address: khaled.ezzedine@aphp.fr.

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