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

BackgroundNarrow-band ultraviolet B (NB-UVB) is an effective and safe treatment for vitiligo. Calcipotriol, a synthetic analogue of 1,25 dihydroxyvitamin D3 may regulate melanin synthesis. Several clinical studies have been conducted but the synergistic effect of addition of calcipotriol to NB-UVB in the treatment of vitiligo is still debatable. ObjectivesTo compare the efficacy and safety of topical calcipotriol (0.005%) in combination with NB-UVB vs. NB-UVB alone in generalized vitiligo. MethodsA prospective right-left comparative study including 27 patients of vitiligo was conducted for 24weeks. On one side, calcipotriol was applied twice a day. NB-UVB was administered thrice a week. Response to treatment was assessed using change in Lund and Browder (L&B) score for percentage reduction in body surface area, investigator's global assessment (IGA) and patient's global assessment (PGA) scores. Treatment related side effects were noted. ResultsMean percentage reduction in L&B score at 24weeks was 51.4% on NB-UVB and 49% on NB-UVB plus calcipotriol side (P=0.557), mean IGA score on NB-UVB was 2.70.5 and on NB-UVB plus calcipotriol was 2.6 +/- 0.4 (P=0.821) and mean PGA score on NB-UVB side was 5.6 +/- 3.4 and on NB-UVB plus calcipotriol side was 5.8 +/- 3.2 (P=0.706). Perifollicular repigmentation that matched with the surrounding normal skin colour was seen in majority of patients on both treatment sides. Calcipotriol produced mild local adverse effects. ConclusionsAddition of calcipotriol to NB-UVB probably does not enhance the efficacy of treatment including extent of repigmentation and time to initial repigmentation. Larger, randomized placebo-controlled trials are required to determine whether addition of calcipotriol has any utility when administered with NB-UVB in the treatment of vitiligo.