Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Skin Res Technol. 2024 Mar;30(3):e13642. doi: 10.1111/srt.13642.
The purpose of this study is to investigate the effectiveness and safety of oral and injectable systemic treatments, such as methotrexate, azathioprine, cyclosporine, tofacitinib, baricitinib, corticosteroids, statins, zinc, apremilast, etc., for treating vitiligo lesions.
Databases including PubMed, Scopus, and Web of Science were meticulously searched for studies spanning from 2010 to August 2023, focusing on systemic oral and injectable therapies for vitiligo, using comprehensive keywords and search syntaxes tailored to each database. Key data extracted included study design, treatment efficacy, patient outcomes, patient satisfaction, and safety profiles.
In a total of 42 included studies, oral mini-pulse corticosteroid therapy (OMP) was the subject of six studies (14.2%). Minocycline was the focus of five studies (11.9%), while methotrexate, apremilast, and tofacitinib each were examined in four studies (9.5%). Antioxidants and Afamelanotide were the subjects of three studies each (7.1%). Cyclosporine, simvastatin, oral zinc, oral corticosteroids (excluding OMP) and injections, and baricitinib were each explored in two studies (4.8%). Azathioprine, mycophenolate mofetil, and Alefacept were the subjects of one study each (2.4%).
Systemic treatments for vitiligo have been successful in controlling lesions without notable side effects. OMP, Methotrexate, Azathioprine, Cyclosporine, Mycophenolate mofetil, Simvastatin, Apremilast, Minocycline, Afamelanotide, Tofacitinib, Baricitinib, Antioxidants, and oral/injectable corticosteroids are effective treatment methods. However, oral zinc and alefacept did not show effectiveness.
本研究旨在探讨甲氨蝶呤、硫唑嘌呤、环孢素、托法替尼、巴瑞替尼、皮质类固醇、他汀类药物、锌、阿普米司特等口服和注射全身治疗方法治疗白癜风皮损的有效性和安全性。
仔细检索了 PubMed、Scopus 和 Web of Science 等数据库，检索时间跨度为 2010 年至 2023 年 8 月，重点关注用于白癜风的全身口服和注射治疗的研究，使用了针对每个数据库的综合关键词和搜索语法。提取的关键数据包括研究设计、治疗效果、患者结局、患者满意度和安全性概况。
在总共 42 项纳入的研究中，口服小剂量皮质类固醇疗法（OMP）有 6 项研究（14.2%）涉及。米诺环素是 5 项研究（11.9%）的重点，甲氨蝶呤、阿普米司特和托法替尼各有 4 项研究（9.5%）涉及。抗氧化剂和阿法美拉汀各有 3 项研究（7.1%）涉及。环孢素、辛伐他汀、口服锌、口服皮质类固醇（不包括 OMP）和注射剂以及巴瑞替尼各有 2 项研究（4.8%）涉及。硫唑嘌呤、霉酚酸酯和阿莱夫西普各有 1 项研究（2.4%）涉及。
全身治疗白癜风皮损成功控制病情，且无明显副作用。OMP、甲氨蝶呤、硫唑嘌呤、环孢素、霉酚酸酯、辛伐他汀、阿普米司特、米诺环素、阿法美拉汀、托法替尼、巴瑞替尼、抗氧化剂和口服/注射皮质类固醇是有效的治疗方法。然而，口服锌和阿莱夫西普无效。
