Vitiligo Clinical Trial
Official title:
Efficacy of Narrow-band UVB Treatment After Transplantation of Harvested Epidermal Cells in Vitiligo
The effect of treatment with narrow-band UVB 311 nm after transplantation of harvested autologous epidermal cells on vitiligo lesions will be investigated.
Introduction: Surgical interventions in vitiligo are widely used and additional UV exposure
is often recommended after successful transplantation. However, little is known about the
additional efficacy of (narrow-band) UVB due to missing comparative studies.
Aim of the study: To perform a prospective, controlled, randomized, intra-individual
comparative study in vitiligo lesions treated with epidermal cell transplantation using the
ReCell method with and without additional narrow-band UVB treatment.
Study design: Two weeks after transplantation of epidermal cells, one randomly chosen half
of the transplanted patch will be additionally treated with narrow-band UVB therapy whereas
the other half will be left untreated. For control purpose, 2 additional patches (or the two
halfs of one patch) will be selected to be treated with either laser dermabrasion and
narrow-band UVB or narrow-band UVB treatment alone.
Grafting with the ReCell method: A superficial skin shaving excision of 2 x 2 cm will be
obtained from pigmented skin (UVA irradiation 4 weeks before the excision) using a Silver
knife. A cell suspension will be obtained using the ReCell transplantation kit, according to
the instructions of the manufactures. The vitiligo skin will be dermabraded by Erbium: Yag
laser after local anaesthesia. Thereafter the cell suspension will be sprayed on the
dermabraded skin area and fixed with special wound dressings.
Narrow-band UVB treatment: The initial UVB dose will be 50% of the minimal erythema dose,
tested next to the vitiligo lesions to be treated. Treatment will be performed 2 times a
week with a targeted UVB device (Dualight, TheraLight). Dose increments will be 30 mJ/cm2 at
each treatment up to a dose that induces slight erythema longer than 24 hours. If this dose
is reached, the dose will be reduced to the last well tolerated dose and no further
increments will follow. Narrow-band UVB treatment will be performed for at least 3 months or
24 treatments.
Evaluation of the treatment success: The grade of pigmentation in all lesions will be
evaluated clinically, with photographs and with laser scanning microscope every 3 weeks
during the first 3 months of the study and later every 3 months within the first year. The
clinical rating will be performed as follows: 0 = no repigmentation; 1 = 1-25%
repigmentation; 2 = 26 to 50% repigmentation; 3 = 51 to 75% repigmentation; and 4 = 76 to
100% repigmentation. The evaluation of the photographs and the laser scanning microscopy
pictures will be performed blinded by physicians not engaged in the treatment phase of the
study.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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