P102 Repigmentation and disease stabilization across medical, phototherapeutic and surgical treatments in vitiligo: a systematic review and meta-analysis

Abstract

Vitiligo management relies on therapies that promote repigmentation and achieve disease stabilization, yet reported outcomes vary widely across studies. A comparative synthesis of available evidence may help inform treatment selection in clinical practice. Our aim was to evaluate pooled repigmentation and stabilization outcomes across major medical, phototherapeutic and surgical treatments used in vitiligo. A systematic review and meta-analysis were performed according to the PRISMA guidelines. PubMed, Embase, Scopus and Web of Science were searched to May 2025. Randomized and observational studies reporting ≥ 50% or ≥ 75% repigmentation and/or stabilization were included. Pooled proportions were calculated using a random effects model. Ninety-two studies comprising 8214 patients met the inclusion criteria. Topical corticosteroids or calcineurin inhibitors achieved ≥ 50% repigmentation in 21% of patients and stabilization in 32%. Narrowband ultraviolet B (NB-UVB) produced ≥ 50% repigmentation in 46% and stabilization in 49%. Combination therapy with topical agents and NB-UVB yielded higher responses (≥ 50% in 58%, ≥ 75% in 34%, stabilization in 55%). Oral minipulse corticosteroids provided the most consistent disease control (74%) but relatively modest repigmentation (28%). Regimens based on Janus kinase inhibitors resulted in ≥ 50% repigmentation in 48% of cases and stabilization in 53%. Surgical procedures, particularly cellular grafting techniques, demonstrated the strongest repigmentation (≥ 75% in 83%) and long-term stability (88%) in stable disease. Surgical interventions and combination therapy provide the most reliable repigmentation, while oral minipulse corticosteroids remain central for stabilizing active disease. Janus kinase inhibitors show encouraging outcomes and may emerge as key agents for disease control. However, progress is limited by the absence of robust biomarkers or standardized criteria to identify stability and to guide therapy selection – an urgent need as newer targeted treatments become available.