The efficacy of ablation-based combination therapy for vitiligo: A systematic review and meta-analysis

Background and objectives: This study aimed to compare the efficacy of vitiligo treatments with and without ablation therapy. Patients and methods: We conducted a systematic review and meta-analysis of literature published before September 15, 2017. Comparative studies of vitiligo patients treated with and without ablation therapy were included. The primary outcome was ≥ 50 % repigmentation. Secondary outcomes were ≥ 75 % repigmentation and patient scores on a subjective visual analogue scale. Results: Fifteen studies with a total of 401 participants were included. The ablation-based combination therapy group had significantly superior results to the control group (odds ratio [OR] for ≥ 50 % repigmentation: 10.490, 95 % confidence interval [CI]: 4.632–23.757; OR for ≥ 75 % repigmentation: 5.812, 95 % CI: 2.194–15.393). Patients receiving ablation-based combination therapy were significantly more satisfied with the efficacy than the control group (standardized mean difference: 1.073, 95 % CI: 0.528–1.619). Subgroup analysis showed that the erbium laser group, CO₂ laser group and fractional CO₂ laser group achieved significantly better repigmentation than the control groups. Conclusions: According to objective and subjective evaluations, treatments for vitiligo are more effective when combined with ablation therapy than when used alone.