The Efficacy of Afamelanotide and Narrowband UV-B Phototherapy for Repigmentation of Vitiligo

JAMA dermatology (Chicago, Ill.) 02/2013; 149(1):68-73. DOI: 10.1001/2013.jamadermatol.386
Source: PubMed


Vitiligo is characterized by depigmented patches of skin due to loss of cutaneous melanocytes. Many recent studies have demonstrated defects in the melanocortin system in patients with vitiligo, including decreased circulating and lesional skin levels of α-melanocyte-stimulating hormone (α-MSH). Afamelanotide is a potent and longer-lasting synthetic analogue of naturally occurring α-MSH.
We describe the preliminary results of 4 patients with generalized vitiligo who developed repigmentation using afamelanotide in combination with narrowband UV-B (NB-UV-B) phototherapy. Patients were treated 3 times weekly with NB-UV-B and starting in the second month received a series of 4 monthly implants containing 16 mg of afamelanotide. Afamelanotide induced faster and deeper repigmentation in each case. All patients experienced follicular and confluent areas of repigmentation within 2 days to 4 weeks after the initial implant, which progressed significantly throughout treatment. All patients experienced diffuse hyperpigmentation.
We propose that afamelanotide represents a novel and potentially effective treatment for vitiligo. The combined therapy of NB-UV-B and afamelanotide appears to promote melanoblast differentiation, proliferation, and eumelanogenesis. Further studies are necessary to confirm these observations.

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    • "In a preliminary result, 4 cases of vitiligo treated with NBUVB combined with melanotrophic hormone synthetic analog afamelanotide obtained diffuse and fast repigmentation, although more studies are needed.38 "
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    ABSTRACT: The Evidence Based Update (EBU) meetings are annual one day meetings held by the Centre of Evidence-Based Dermatology (CEBD) at the University of Nottingham. The aim of the meeting is to discuss high quality evidence, mainly in the form of systematic reviews and randomised controlled trials (RCTs), on a different topic each year. The meetings are designed to be interactive with a panel discussion between international experts and delegates forming a key part of the meeting. The 11(th) EBU meeting was on vitiligo and took place on 23(rd) May 2013 in Loughborough, UK. The most recent research including new and unpublished studies was presented on the classification of vitiligo, the evidence behind different treatment options and current guidelines for vitiligo. This article is protected by copyright. All rights reserved.
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