![]() Investigators observed the most common pattern of repigmentation was diffuse in the clobetasol propionate arm, while it was diffuse and mixed in the tacrolimus arm.Ībout a quarter of patients on placebo did respond to therapy (24 percent). Moreover, investigators found statistically significant differences in response between patients receiving clobetasol proprionate and patients receiving tacrolimus versus placebo, p<0.0001 and p=0.0004, respectively. "We saw with tacrolimus, however, that the facial lesions seem to be responding much better (than nonfacial lesions)," she says. "The response with clobetasol appeared to be equivalent between facial and nonfacial lesions," Dr. When comparing the nonfacial group, 39 percent of the clobetasol propionate arm responded successfully versus 23 percent of patients receiving tacrolimus therapy, p=0.30. Researchers found equal rates of efficacy between the clobetasol propionate arm (58 percent) and the tacrolimus arm (58 percent) in the facial group, with the difference not being statistically significant. They measured improvement through photographs captured at the study entry, two months, four months and six months. Investigators defined successful repigmentation as greater than 50 percent improvement. Patients were further stratified to "face" and "nonface" groups, Dr. Patients were randomized to either clobetasol propionate 0.05 percent ointment for two months on and two months off (33) tacrolimus 0.1 percent ointment (34) or six months of placebo (33). Patients were excluded from the study if they showed signs of infection stemming from the application of therapy. There was a washout period of at least four weeks. Patients in the study, ages 2 to 16, with less than 20 percent body surface area of vitiligo were recruited from two different sites. The prospective, randomized, double-blinded, placebo-controlled study saw 100 children randomized to one of three groups for six months. "The objective of our clinical study was to compare the efficacy of the treatment with placebo," she says. ![]() Ho tells Dermatology Times that both clobetasol proportionate 0.05 percent and tacrolimus 0.1 percent have been shown to be effective and safe in treating vitiligo, but specific research in the pediatric population has not been conducted to support which is the safer and more effective choice.Ĭurrent therapy used at the Hospital for Sick Children for children with vitiligo involves the use of clobetasol proportionate 0.05 percent being applied for six to eight weeks in an on-and-off cycle, with tacrolimus 0.1 percent being used on the face, Dr. The data from that study suggested more intermittent treatment with corticosteroids would be more likely to forestall the onset of local side effects.ĭr. Ho, assistant professor at the University of Toronto, Toronto. Some retrospective research published last year demonstrated efficacy with corticosteroids to treat the condition, but local side effects occurred with their continual use, according to Dr. ![]() Ho says, but the theory that the condition is autoimmune in nature is widely accepted. ![]() The pathogenesis of the condition remains unknown, Dr. ![]()
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