Original Title: Láser o luz excimer en 308nm en pacientes con vitíligo

Authors' recommendations: No significant differences have been found regarding net benefit in the evidence surveyed when assessing 308-nm excimer laser vs. 308-nm excimer light; therefore this document analyzes both devices simultaneously for the treatment of vitiligo. Low-quality evidence suggests that using 308-nm excimer laser and 308-nm excimer light might improve pigmentation of vitiligo lesions, similarly to standard therapy with broad-band ultraviolet B radiation (BBUVB), considered one of the first line therapies. However, whether repigmentation is long-lasting or results in quality of life improvement is unknown. No evidence directly comparing the effectiveness of 308-nm excimer laser or 308-nm excimer light versus other first line therapies (such as topical corticosteroids, topical calcineurin inhibitors) or second line therapies (such as psoralen plus long-wave ultraviolet light [PUVA], vitamin D analogues) has been found. The studies analyzed compare combining topical therapies with 308-nm excimer laser or 308-nm excimer light versus using these technologies as monotherapy; they suggest that combining therapies would result in better repigmentation results when compared with the use of these technologies as monotherapy. In pediatric patients, evidence from one study, showed that combining the use of 308-nm excimer laser with other topical therapies results in better repigmentation when compared with laser as monotherapy. When considering excimer light use for facial vitiligo, the results of one study suggest that there are no differences in repigmentation percentage when excimer light was used along with topical corticosteroids versus excimer light as monotherapy. The clinical practice guidelines and the expert consensus reviewed consider 308-nm excimer laser use as a second or third line therapy option, in combination with other topical therapies and mainly for pediatric patients or those with small lesions. Most clinical practice guidelines do not mention excimer light as therapy. The public health sponsors form Argentina and other selected countries from America and Europe consulted do not mention or do not cover this technology. Other private United States health sponsors surveyed, Aetna, Cigna and Healthnet, cover excimer laser for vitiligo treatment. No local or international economic assessments of its cost-effectiveness or other economic aspects related to the use of 308-nm excimer laser for vitiligo treatment have been found.

Project Status: Completed

Year Published: 2022

URL for published report: https://www.iecs.org.ar/publicacion/?id=21845

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)