Ultraviolet phototherapy (particularly narrow band UVB therapy) is an effective treatment for vitiligo but often requires frequent appointments and time commitment at a clinic or institution. Self-administered treatment using home-based Phototherapy such as handheld devices are an alternative with limited evidence. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness and safety of home-based phototherapy in vitiligo.
Methods: Searches were conducted on Medline, Cochrane and Embase for studies using home-based ultraviolet B (UVB) phototherapy for treatment of vitiligo. The primary outcome was treatment effectiveness, reported in the proportion of patients achieving >50% and >75% repigmentation. Secondary outcomes assessed were adverse events, cost and adherence.
Results: fifteen studies were included with a total of 1060 vitiligo patients. Of these, 4 studies (247 patients, 126 home-based UVB and 121 hospital/institution-based UVB) could be used for meta-analysis. Home-based UVB was not inferior to hospital-based UVB at achieving both >50% (47.6% vs 47.9%) and >75% repigmentation (22.2% vs 19.0%). Home-based UVB was not associated with a statistically significant increase in risk for either erythema or burning sensations when compared to hospital-based UVB. There was a 14% lower rate of discontinuation amongst patients using home-based UVB.
Conclusions and Significance/Impact: Home-based UVB therapy is not inferior to hospital based UVB therapy in efficacy, rate of adverse events and demonstrates favourable adherence. Home-based phototherapy may be a safe and effective method in delivering treatment to vitiligo patients unable or not willing to access long-term institutional phototherapy.