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一项开放标签、非随机的初步非劣效性研究:比较家用手持式窄带紫外线B光梳设备与标准的基于医院的全身窄带紫外线B光疗法治疗局限性白癜风的疗效

An Open-Label Non-Randomized Preliminary Noninferiority Study Comparing Home-Based Handheld Narrow-Band UVB Comb Device with Standard Hospital-Based Whole-Body Narrow-Band UVB Therapy in Localized Vitiligo.

作者信息

Singh Suvesh, Khandpur Sujay, Sharma Vinod K, Bhari Neetu, Pandey Ravindra M

机构信息

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Department of Biostatistic, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian Dermatol Online J. 2023 Jun 28;14(4):510-515. doi: 10.4103/idoj.idoj_604_22. eCollection 2023 Jul-Aug.

DOI:10.4103/idoj.idoj_604_22
PMID:37521207
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10373828/
Abstract

BACKGROUND

Narrow-band ultraviolet B (NB-UVB) is the standard therapy for vitiligo.

OBJECTIVE

The objective of this study is to compare the safety and clinical efficacy of a handheld NB-UVB comb device with the standard whole-body NB-UVB therapy in localized stable vitiligo.

MATERIALS AND METHODS

Thirty-one vitiligo patients were allocated to either daily therapy with a home-based handheld comb device (group A, = 17) or thrice-weekly hospital-based whole-body NB-UVB therapy (group B, = 14) for 4 months, based on their preference. The primary and secondary outcomes were assessed at each follow-up, and appropriate statistical tools were used for analysis.

RESULTS

Of the 31 patients enrolled, 26 patients (study groups A/B: 15/11) completed the study. Primary outcome: Median percentage repigmentation of the representative patch in groups A and B were 51.35% and 63.85%, respectively ( = 0.64). The median size reduction of the representative patch in both groups was statistically significant ( < 0.05). The mean difference between "per protocol analysis" and "intention to treat" showed noninferiority. Secondary outcomes: Both groups were comparable on Lund and Browder score, patient global assessment and investigator global assessment scores, adverse events, color match, and change in the quality of life. The comparison group had a significantly greater number of missed sessions ( = 0.02). The majority of patients had a "good" response in both groups.

CONCLUSION

Handheld NB-UVB comb device daily with a fixed dose of fluence was found to be noninferior with better compliance to standard whole-body NB-UVB therapy.

摘要

背景

窄谱中波紫外线(NB-UVB)是白癜风的标准治疗方法。

目的

本研究的目的是比较手持NB-UVB梳子装置与标准全身NB-UVB疗法治疗局限性稳定期白癜风的安全性和临床疗效。

材料与方法

31例白癜风患者根据自身偏好,被分配至每日在家使用手持梳子装置治疗组(A组,n = 17)或每周3次在医院进行全身NB-UVB治疗组(B组,n = 14),治疗4个月。每次随访时评估主要和次要结局,并使用适当的统计工具进行分析。

结果

31例入组患者中,26例(A/B研究组:15/11)完成了研究。主要结局:A组和B组代表性皮损的色素再生中位数百分比分别为51.35%和63.85%(P = 0.64)。两组代表性皮损的大小中位数减小具有统计学意义(P < 0.05)。“符合方案分析”与“意向性分析”之间的平均差异显示非劣效性。次要结局:两组在伦德和布劳德评分、患者整体评估和研究者整体评估评分、不良事件、颜色匹配以及生活质量变化方面具有可比性。对照组错过治疗的次数明显更多(P = 0.02)。两组中大多数患者有“良好”反应。

结论

发现每日使用固定剂量能量密度的手持NB-UVB梳子装置与标准全身NB-UVB疗法相比非劣效,且依从性更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b6f/10373828/77a81d6c1906/IDOJ-14-510-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b6f/10373828/902b81dc4940/IDOJ-14-510-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b6f/10373828/77a81d6c1906/IDOJ-14-510-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b6f/10373828/902b81dc4940/IDOJ-14-510-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b6f/10373828/77a81d6c1906/IDOJ-14-510-g002.jpg

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本文引用的文献

1
British Association of Dermatologists guidelines for the management of people with vitiligo 2021.英国皮肤科医师协会2021年白癜风患者管理指南
Br J Dermatol. 2022 Jan;186(1):18-29. doi: 10.1111/bjd.20596. Epub 2021 Sep 7.
2
Narrow-band ultraviolet B comb as an effective home-based phototherapy device for limited or localized non-segmental vitiligo: A pilot, open-label, single-arm clinical study.窄谱中波紫外线梳子作为一种有效的家庭光疗设备用于局限性或非节段性白癜风:一项先导性、开放标签、单臂临床研究。
Indian J Dermatol Venereol Leprol. 2020 May-Jun;86(3):298-301. doi: 10.4103/ijdvl.IJDVL_476_19.
3
Home vs hospital narrowband UVB treatment by a hand-held unit for new-onset vitiligo: A pilot randomized controlled study.
家庭与医院手持单元窄谱 UVB 治疗新发白癜风:一项随机对照研究。
Photodermatol Photoimmunol Photomed. 2020 Jan;36(1):14-20. doi: 10.1111/phpp.12495. Epub 2019 Jun 27.
4
Comparison of efficacy and safety profile for home NB-UVB vs. outpatient NB-UVB in the treatment of non-segmental vitiligo: A prospective cohort study.家庭 NB-UVB 与门诊 NB-UVB 治疗非节段性白癜风的疗效和安全性比较:一项前瞻性队列研究。
Photodermatol Photoimmunol Photomed. 2019 Jul;35(4):261-267. doi: 10.1111/phpp.12462. Epub 2019 Mar 25.
5
The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.《白癜风工作组关于窄谱中波紫外线光疗治疗白癜风的建议》。
J Am Acad Dermatol. 2017 May;76(5):879-888. doi: 10.1016/j.jaad.2016.12.041. Epub 2017 Feb 16.
6
Comparison of efficacy and safety profile of topical calcipotriol ointment in combination with NB-UVB vs. NB-UVB alone in the treatment of vitiligo: a 24-week prospective right-left comparative clinical trial.外用卡泊三醇软膏联合窄谱中波紫外线(NB-UVB)与单用NB-UVB治疗白癜风的疗效和安全性比较:一项为期24周的前瞻性左右对照临床试验。
J Eur Acad Dermatol Venereol. 2015 May;29(5):925-32. doi: 10.1111/jdv.12726. Epub 2014 Sep 15.
7
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