Vitiligo is a chronic skin disorder that affects millions of individuals worldwide. The condition is characterized by the loss of pigmentation of the skin and even hair, typically when the melanin-producing melanocytes in the body are destroyed.
Although no definitive cure for vitiligo has been found, we can’t forego that advancements in treatment have made concealing and treating the symptoms quite accessible for patients.
Recent studies and ongoing clinical studies indicate that the future of vitiligo treatment is highly promising in improving the patient’s disease state and overall quality of life.
However, a recent preliminary study has shown promising results in treating Vitiligo using a combination of afamelanotide and Narrowband UVB therapy. This article will look into an in-depth analysis of the study, discuss the findings and also explore the future implications of these advanced treatments in treating vitiligo.
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Overview of the Study
The study’s findings we will discuss and highlight in this article is a review conducted via a literature search involving data from PubMed and the National Institutes of Health’s clinicalTrials.gov databases between January 2010 to July 2015.
74 studies were reviewed to look into medical and surgical treatment modalities for vitiligo.
Amidst them, two factors that stood out were understanding the efficacy and safety of afamelanotide, a synthetic analog of α-MSH, in combination with Narrowband UVB therapy for Vitiligo treatment.
The objective was to understand how combining these two individual treatment methods into one could promote repigmentation and improve the overall quality of life of Vitiligo patients.
| Related: 10 myths and facts around vitiligo you should know first |
Understanding the Basics First
Before we explore the combined impacts of afamelanotide with Narrowband UVB, we first need to understand these two factors individually.
Afamelanotide: An Introduction
Afamelanotide is a synthetic analog of α-MSH, a naturally occurring hormone that regulates pigmentation.
Its primary function is to bind to the melanocortin-1 receptors in the melanocytes, which, in turn, triggers the production of melanin, the pigment responsible for the distinct color of our skin, hair, eye color, etc.
Afamelanotide’s melanogenesis-inducing properties make it a promising candidate for treating impaired or deficient pigmentation conditions, such as Vitiligo. Not just Vitiligo, afamelanotide has been studied to treat various other skin disorders, including erythropoietic protoporphyria (EPP).
Furthermore, Afamelanotide is administered as a subcutaneous implant (the same as was observed in this study). The implant is responsible for the sustained or controlled release of the medication in the body.
Overall, afamelanotide offers a unique approach to Vitiligo treatment by targeting melanocyte function and promoting melanin production. More on that will be discussed later.
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| Related: 10 Ways To Increase The Melanin Naturally In Your Skin |
Narrowband UVB Therapy: An Introduction
With a basic understanding of afamelanotide out of the way, the next thing we must look into further is using Narrowband UVB (NB UVB) for vitiligo treatment.
Ultraviolet therapy is one of the most praised treatment options for vitiligo. It is often paired with “innate and cellular immunosuppressive” to promote melanin production in the skin and re-pigment the areas with white patches and macules.
Since this article focuses on UVB and its use in treating vitiligo, let us keep UVA out of the equation for now.
UVB therapy is targeted phototherapy that exposes the affected skin to a narrow range of ultraviolet B wavelengths, primarily between 311-312 nanometers. Certain studies indicate that the use of broad-band UVB therapy has more promising effects as opposed to NB UVB.
However, we fail to realize that broad-band UVB uses harmful wavelengths, which might not be ideal for the skin.
The study conducted by Bansal et al found a notable reduction in the “Vitiligo Area Severity Index (VASI)” in patients that underwent the NB UVB therapy. Not just that, this type of phototherapy also assures better color matching and is thus a preferred line of treatment for many vitiligo patients.
| Related: What Are The Main Reason For Spreading Of Vitiligo And How I Can Stop It |
Study Findings
Now that we have a clear and individual understanding of afamelanotide and narrow-band UVB as individual effective treatments for vitiligo, the next focus of the article is to find a correlation between the effects of the combined use of these two treatments.
According to the findings of a recent study, the researcher concluded, “afamelanotide (16 mg subcutaneous implant) along with Narrowband UVB has promising results In Vitiligo.”
Let us break it down further.
First study:
- The findings are sourced from a small pilot study where afamelanotide (16mg implant) was implanted monthly in four patients one month after the start of NB UVB therapy, which was done thrice a week.
- The researchers found significant improvements in repigmentation within a month after initiating the combined treatment. The patients also noticed diffusion of the hyperpigmentation of the GV lesions on the skin.
Second study:
- In a subsequent Phase 1/2 study involving 55 patients, a comparison was made between combination therapy using 7 to 10-day release afamelanotide 16mg bioresorbable implants along with Narrowband UVB (NB-UVB) therapy and NB-UVB therapy alone.
- According to the results, the combination therapy (afamelanotide with NB-UVB) led to faster repigmentation of the facial vitiligo patches in the patients (within 41 days) and upper extremity lesions (within 61 days) compared to the NB-UVB therapy alone.
- Furthermore, the combination therapy also demonstrated a better six-month repigmentation rate in patients with non-segmental vitiligo.
These clinical findings highlight the potential benefits of combining afamelanotide implants with NB-UVB therapy for Vitiligo treatment. The faster repigmentation observed in facial and upper extremity lesions suggests that this treatment approach may be particularly effective for these areas commonly affected by Vitiligo.
Side note: It is important to keep in mind that the use of afamelanotide treatment may induce hyperpigmentation of normal skin, which, in turn, can accentuate the contrast between the pigmentation between the unaffected parts and the affected parts on the skin due to vitiligo. People with lighter skin tones, so this particular factor should be taken into consideration.
| Related: Is Vitiligo Related to Hereditary Or is It Genetic |
Limitations and Further Research
While the benefits of the combination therapy using afamelanotide and NB-UVB seem quite promising for reducing the effects of vitiligo in patients, we also have to prioritize the limitations that come with these clinical findings.
Firstly, the sample size was relatively small, which may limit the generalizability of the findings.
Secondly, the study’s duration was relatively short, so there is a dire need for long-term and more comprehensive research to reach tangible conclusions.
Further research with larger sample sizes, longer follow-up periods, and comparative studies with other treatment modalities is warranted to validate the efficacy, safety, and optimal protocol for this combination treatment approach.
The future of vitiligo treatment seems extremely promising, especially with the advancements we have noticed in the research for a new medication for vitiligo, therapies, and surgical procedures.
It is important to understand that light therapy is developed for cold nations that do not receive adequate sunlight. In a country like India, where sunlight is plenty, the application of Sargan plus ointment with 15 minutes of sun exposure produces the same level of re-pigmentation achieved by UVB therapy at a fraction of the cost.
Sargan plus ointment is a herbal preparation prepared by the doctors at Kayakalp Global and has been used by thousands of patients who have achieved great results.
It is also important to understand that any new drug will need extensive research and subsidy to be available to the masses in India at affordable prices; till then, we need to rely on combination therapy developed by Kayakalp Global.
| Related: Best Vitiligo Treatment in Delhi |
Conclusion
The recent preliminary study exploring the combination of afamelanotide and Narrowband UVB therapy for Vitiligo has demonstrated very promising results. It is posing as an effective and well-tolerated treatment option for promoting repigmentation for Vitiligo patients.
At Kayakalp Global, our team of doctors is consistently tailoring the treatment with the latest, effective, and approved medical treatments to restore the quality of life of our patients. Given how promising the combination therapy of afamelanotide and NB-UVB looks, our team is constantly keeping up with the ongoing research and looking forward to the ongoing advancements in Vitiligo management.
