Comparative study of the effectiveness of combination therapy of vitiligo with methotrexate in combination with medium-wave narrow-band therapy UVB-311 nm and monotherapy UVB-311 nm

Abstract

BACKGROUND: Vitiligo, a multifactorial chronic acquired disease with a genetic predisposition, occurs due to the destruction of melanocytes of the skin and is characterized by the appearance of foci of depigmentation. Despite the fact that new therapies are emerging, there are no actual treatment regimens that would guarantee a positive result, including stopping the progression of the process, repigmentation. In this regard, it is advisable to search for drugs that have an immunosuppressive effect.

AIMS: Clinical evaluation of the effectiveness of methotrexate in combination with UVB-311 nm and UVB-311 nm monotherapy in vitiligo.

MATERIALS AND METHODS: 77 patients suffering from progressive vitiligo were included in this study. All patients were divided into 2 groups. A course of methotrexate therapy in combination with UV therapy was prescribed to 39 patients, UVB-311 nm monotherapy was performed in 38 patients. The lesion area relative to the body surface area was estimated using the VES index (Vitiligo extent score) on the vitiligo calculator. The effect of the disease on the quality of life was assessed using the Dermatology Life Quality Index (DLQI). The duration of the study was 6 months.

RESULTS: The patients included in the study were divided into two groups randomly. There were 39 patients in group I, 38 in group II. 76 out of 77 patients completed it: 1 patient was excluded due to increased hepatic transaminases during methotrexate therapy. Among patients receiving combination therapy with methotrexate in combination with medium-wave narrow-band therapy UVB-311 nm, there was a more pronounced decrease in the percentage of depigmentation relative to the body surface area. And also patients of this group demonstrated the most active positive dynamics of the Dermatology Life Quality Index than patients who received only phototherapy.

CONCLUSIONS: The study demonstrated good clinical efficacy of the drug. Small doses of methotrexate have a positive effect on the tolerability of the drug and prevent the development of side effects, which makes it possible to influence pathogenetic mechanisms for a long time, stabilizing the skin process.

Keywords

vitiligo / treatment of vitiligo / autoimmunity / immunosuppressive drugs / methotrexate

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