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.


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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