Apremilast and Narrow-Band UVB Improves Repigmentation Rate in Patients With Vitiligo and Skin of Color

Combining apremilast with narrow-band (NB) ultraviolet B (UVB) phototherapy may speed up repigmentation in patients with skin of color and generalized vitiligo, a study published in the Journal of the American Academy of Dermatology suggests.

A total of 28 patients with vitiligo and skin phototypes IV to VI were enrolled in this single-center, split-body study. The right or left affected body sides were randomly assigned to undergo either treatment with apremilast plus NB-UVB or NB-UVB alone.

The NB-UVB-alone treatment included the use of NB-UVB a total of 2 or 3 times a week during weeks 0 to 16 followed by occlusion with a half-sided skin covering during weeks 16 to 32. The combination treatment (regimen B) consisted of skin occlusion during weeks 0 to 16 followed by treatment with apremilast and NB-UVB during weeks 16 to 32 on the previously untreated body side.

Of the 28 patients included in the screening phase, 14 patients completed all study visits. The combination regimen was associated with a significantly greater probability of achieving the primary endpoint of grade 3 or 4 repigmentation after 16 weeks (P =.001).

In addition, there was a greater reduction in the mean Vitiligo Area Scoring Index (P =.0001) and Body Surface Area (P =.0001) after 16 weeks of apremilast with NB-UVB compared with NB-UVB alone. There were no differences between the treatment groups regard to the Dermatology Life Quality Index or Visual Analog Scale scores (P >.05).

Limitations of this study include its relatively short follow-up period, the small number of patients, and the variability in the number of NB-UVB treatments administered per week.

The researchers noted that the “trial serves as a clear proof-of-concept,” but given the limitations, they “recommend further studies with larger sample size” to determine generalizable conclusions about the combo regimen.

Disclosures: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.  

Reference

Kim HJ, Singer G, Abittan BJ, et al. Combination of apremilast and narrowband UVB in the treatment of generalized vitiligo in skin types IV-VI: A randomized split-body pilot study. Published online January 10, 2021. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.12.073