Calcipotriol 50micrograms/ml scalp solution

Vitiligo is a depigmentation disorder whose treatment remains a serious challenge. While it is generally accepted that topicals and phototherapy are helpful for generalized symmetric disease, randomized controlled trials (RCTs) provide the best evidence for treatment. Our objective was to identify and summarize RCTs for vitiligo from 2013 to 2023. A systematic review registered with the International Prospective Register of Systematic Reviews (PROSPERO) was performed per PRISMA guidelines. We searched CENTRAL, ClinicalTrials.gov, Embase, PubMed, and Web of Science for RCTs using keywords such as 'vitiligo' and/or 'treatment' or 'intervention.' A total of 652 studies underwent full-text review, and 151 studies met the inclusion criteria. We focused our study on RCTs using the vitiligo area scoring index (VASI) as the primary outcome measure, leading to 36 studies. We further narrowed our focus to studies that could be aggregated into the intervention categories: phototherapy and systemic combination therapy (n=10), topical and topical combination therapy (n=15), and systemic monotherapy (n=5).  Treated versus control subjects showed statistically improved VASI after the following interventions were added to phototherapy: oral psoralen, oral minipulsed prednisone, implanted afamelanotide, topical ethyl vanillate, topical bimatoprost, and oral vitamins A and E. Effective topical therapies were ruxolitinib, calcipotriol and betamethasone, tacrolimus and mometasone, and microdermabrasion and tacrolimus. None of the systemic monotherapies was superior to their corresponding comparator.

Abstract licence: CC BY

Background: Alopecia areata (AA) is an autoimmune disease with various treatment modalities. It ranges in severity from patchy hair loss, which often resolves spontaneously, to severe, chronic cases that may result in complete loss of body and scalp hair. Objectives: The present study aimed to compare the effectiveness of topical calcipotriol, intralesional autologous platelet-rich plasma (PRP) injection, and a combination of topical calcipotriol with intralesional autologous PRP injection in patients with AA. Methods: In this randomized clinical trial, 78 patients with AA were divided into three groups. The first group received topical calcipotriol 0.005% twice daily for three months with follow-up. The second group underwent intralesional PRP injection for six consecutive sessions at two-week intervals. The third group received both treatments. Results: A substantial reduction in the average Severity of Alopecia Tool (SALT) score was observed in all three groups (P-value = 0.001) following treatment. The absolute reductions were 3.73 points in the calcipotriol group, 6.87 points in the PRP group, and 18.98 points in the combination group. The reduction was significant (P-value = 0.001), most pronounced in the combination group, followed by the PRP group, and then the calcipotriol group. A notable decline in dermoscopic results was observed post-treatment across all three groups. Conclusions: This study concluded that topical calcipotriol, intralesional autologous PRP injection, and their combination were significantly effective in reducing SALT scores in patients with AA. This reduction was most evident in the combination group, followed by the PRP group, and then the calcipotriol group.

Abstract licence: CC BY-NC 4.0