Comparison of Cyclic On-off and Continuous Excimer Laser Treatment for Vitiligo

NCT ID: NCT03047733

Last Updated: 2017-02-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-21

Study Completion Date

2016-12-31

Brief Summary

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OBJECTIVE: To investigate the efficacy of the cyclic on-off treatment compared to the conventional continuous excimer laser treatment.

DESIGN: A randomized, controlled, split-body, non-inferiority study. SETTING: The trial was performed in two tertiary health care centers in Korea.

PARTICIPANT: Twelve patients (16 pairs of lesions) with stable symmetric vitiligo less than 5 years' disease duration were enrolled.

INTERVENSION: The paired symmetric vitiliginous lesions were randomized to either the continuous or the cyclic on-off treatment. All lesions were treated twice weekly for 9-month: continuously, or cyclically with 2-month treatment and 1-month intermission (total 3 cycles). Topical tacrolimus was applied throughout the trial.

OUTCOME MEASURES: The repigmentation was assessed using an image analysis program with clinical photographs. The primary outcome was mean difference of repigmentation rates and the non-inferiority margin was set at 10%. During intermission period, the clinical changes such as loss of repigmentation or worsening of the vitiligo lesions were assessed.

Detailed Description

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\[Study design and population\] A randomized, controlled, split-body, non-inferiority trial was designed.

After obtaining informed consent, 12 patients with stable symmetric vitiligo less than 5 years' disease duration were enrolled.

The patients taking systemic steroids or having enlarging lesions were excluded. The paired symmetric vitiliginous lesions were randomized to either the continuous or the cyclic excimer laser treatment.

Total duration of study was 9 months.

In cyclic excimer laser treatment, the cycle was arbitrarily determined that one cycle consists of a 2-month treatment period (on) and a consecutive 1-month intermission period (off) (total 3 cycles during the trial).

\[Treatment protocol\]

The lesions were treated twice a week. Initial irradiation dose was 50 mJ/cm2 on face and 100 mJ/cm2 on trunk and extremities. If there had not been minimal asymptomatic erythema, energy level was escalated by 50 mJ/cm2. In cyclic treatment, the treatment resumed after intermission with the previously used irradiation dose.

Topical tacrolimus 0.1% ointment was applied in both twice daily throughout whole length of the trial.

\[Assessment and primary outcome\] Photographic documentation of lesions was conducted every month and the degree of repigmentation was assessed with a repigmentation rate (%) from the baseline by using an image analysis program (Digital Researcher for Vitiligo Area Evaluation, Dr. VAE, Korea).

An intention-to-treat analysis was planned, and last observation carried forward method was applied to impute the missing value in the presence of dropouts.

The primary outcome was mean difference of quantitative changes in repigmented area between continuous and cyclic on-off treatment. The non-inferiority margin was set at 10%. During intermission period in the cyclic treatment, the clinical changes such as loss of repigmentation or worsening of the vitiligo lesions were assessed.

\[Statistical analysis\] All statistical analyses were conducted using R 3.2.4 (R Foundation for Statistical Computing, Austria) and a P value \<0.05 was considered statistically significant.

Conditions

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Dermatologic Disease Vitiligo

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized, controlled, split-body, non-inferiority trial.

Patients with stable symmetric vitiligo were enrolled. The paired symmetric vitiliginous lesions were randomized to either the continuous or the cyclic on-off excimer laser treatment.

Total duration of study was 9 months.

In cyclic on-off excimer laser treatment, the cycle was arbitrarily determined that one cycle consists of a 2-month treatment period (on) and a consecutive 1-month intermission period (off).
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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continuously excimer laser treatment

In this group, lesions treated twice weekly through out the whole trial length (9 months).

Application of topical tacrolimus 0.1% ointment through out the whole trial length (9 months).

Group Type ACTIVE_COMPARATOR

The XTRAC Excimer Laser System

Intervention Type DEVICE

Initial irradiation dose was 50 mJ/cm2 on face and 100 mJ/cm2 on trunk and extremities. If there had not been minimal asymptomatic erythema, energy level was escalated by 50 mJ/cm2.

Topical tacrolimus 0.1% ointment

Intervention Type DRUG

Application of topical tacrolimus 0.1% ointment on the both lesions once daily.

cyclic excimer laser treatment

In this group, one cycle consists of a 2-month treatment period (on) and a consecutive 1-month intermission period (off).

Total 3 cycles of cyclic treatment through out the whole trial length (9 months). During the treatment period, lesions treated twice weekly.

Application of topical tacrolimus 0.1% ointment through out the whole trial length (9 months).

Group Type EXPERIMENTAL

The XTRAC Excimer Laser System

Intervention Type DEVICE

Initial irradiation dose was 50 mJ/cm2 on face and 100 mJ/cm2 on trunk and extremities. If there had not been minimal asymptomatic erythema, energy level was escalated by 50 mJ/cm2.

Topical tacrolimus 0.1% ointment

Intervention Type DRUG

Application of topical tacrolimus 0.1% ointment on the both lesions once daily.

Interventions

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The XTRAC Excimer Laser System

Initial irradiation dose was 50 mJ/cm2 on face and 100 mJ/cm2 on trunk and extremities. If there had not been minimal asymptomatic erythema, energy level was escalated by 50 mJ/cm2.

Intervention Type DEVICE

Topical tacrolimus 0.1% ointment

Application of topical tacrolimus 0.1% ointment on the both lesions once daily.

Intervention Type DRUG

Other Intervention Names

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XTRAC Velocity 400

Eligibility Criteria

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Inclusion Criteria

* Patients with symmetric vitiligo
* Patients with less than 5 years' disease duration

Exclusion Criteria

* The patients taking systemic steroids
* The patients with currently enlarging lesions
* The patients who cannot follow the treatment schedule
Minimum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ajou University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Jae Min Sung

Resident of the department of dermatology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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HEE YOUNG KANG, M.D., Ph.D.

Role: STUDY_DIRECTOR

Ajou University School of Medicine

Locations

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Ajou university hospital

Suwon, Gyeonggi-do, South Korea

Site Status

Countries

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South Korea

References

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Zhang XY, He YL, Dong J, Xu JZ, Wang J. Clinical efficacy of a 308 nm excimer laser in the treatment of vitiligo. Photodermatol Photoimmunol Photomed. 2010 Jun;26(3):138-42. doi: 10.1111/j.1600-0781.2010.00509.x.

Reference Type BACKGROUND
PMID: 20584252 (View on PubMed)

Hofer A, Hassan AS, Legat FJ, Kerl H, Wolf P. Optimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients. Br J Dermatol. 2005 May;152(5):981-5. doi: 10.1111/j.1365-2133.2004.06321.x.

Reference Type BACKGROUND
PMID: 15888156 (View on PubMed)

Park KK, Liao W, Murase JE. A review of monochromatic excimer light in vitiligo. Br J Dermatol. 2012 Sep;167(3):468-78. doi: 10.1111/j.1365-2133.2012.11008.x. Epub 2012 Aug 8.

Reference Type BACKGROUND
PMID: 22524428 (View on PubMed)

Aberdam E, Romero C, Ortonne JP. Repeated UVB irradiations do not have the same potential to promote stimulation of melanogenesis in cultured normal human melanocytes. J Cell Sci. 1993 Dec;106 ( Pt 4):1015-22. doi: 10.1242/jcs.106.4.1015.

Reference Type RESULT
PMID: 7907336 (View on PubMed)

Other Identifiers

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AJIRB-MED-DE3-15-151

Identifier Type: -

Identifier Source: org_study_id

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