The efficacy of combined phototherapy with topical therapy in vitiligo: a network meta-analysis

• Published in: The Journal of dermatological treatment Vol. 36; no. 1; p. 2483808
• Main Authors: Luo, Liping, Huang, Jinhua, Fu, Chuhan, Hu, Yibo, Chen, Jing, Jiang, Ling, Zeng, Qinghai
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01.12.2025
• Subjects: Administration, Cutaneous; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Antioxidants - administration & dosage; Antioxidants - therapeutic use; Calcineurin Inhibitors - administration & dosage; Calcineurin Inhibitors - therapeutic use; Combined Modality Therapy - methods; Combined treatment; Humans; Lasers, Excimer - therapeutic use; Lasers, Gas - therapeutic use; Low-Level Light Therapy - methods; network meta-analysis; phototherapy; Phototherapy - methods; Randomized Controlled Trials as Topic; Skin Pigmentation - drug effects; Skin Pigmentation - radiation effects; topical therapy; Treatment Outcome; Ultraviolet Therapy - methods; vitiligo; Vitiligo - therapy; vitiligo; Combined treatment; phototherapy; network meta-analysis; topical therapy
• ISSN: 0954-6634; 1471-1753; 1471-1753
• DOI: 10.1080/09546634.2025.2483808

The comparative effects of phototherapy and topical therapy in patients with vitiligo remain unclear. A network meta-analysis (NMA) was conducted to assess which combination therapy was more beneficial for patients with vitiligo. This study analyzed phototherapy, including narrowband ultraviolet B (NB-UVB) and 308-nm excimer laser/light (EL) combined with topical therapies. Randomized controlled trials were sourced from PubMed, Embase, and Cochrane Library. Data analysis was based on a random-effects model, and surface under the cumulative ranking (SUCRA) curves employed to assess the efficacy of the interventions. This NMA included 27 trials, with a total of 2417 lesions (patches). According to the results of the SUCRA, for achieving ≥50% repigmentation, the top three combination therapies were phototherapy combined with antioxidants (SUCRA 87.7), corticosteroids (SUCRA 69.6), and calcineurin inhibitors (SUCRA 52.5), while for ≥75% repigmentation, the leading therapies were phototherapy combined with antioxidants (SUCRA 89.0), calcineurin inhibitors (SUCRA 70.3), and fractional CO laser (SUCRA 63.6). This meta-analysis suggests that combining phototherapy with topical antioxidants, corticosteroids, or calcineurin inhibitors may offer superior outcomes for vitiligo patients. This study provides a reference for clinicians to develop personalized treatment plans for patients with vitiligo.