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Narrowband UVB for vitiligo linked to lower fracture risk

Journal of the American Academy of Dermatology
Reuters Health - 18/09/2020 - Vitiligo patients who receive long-term narrowband UVB phototherapy are at lower risk of major osteoporotic fractures, new research shows.

"Systemic phototherapy to treat vitiligo can unexpectedly reduce the risk of fractures. These findings were more pronounced in older women," Dr. Jung Min Bae of St. Vincent's Hospital at the Catholic University of Korea in Seoul, the study's senior author, told Reuters Health by email. "Narrowband UVB phototherapy not only improves vitiligo, but may also have accidental health benefits."

Narrowband UV-B (NB-UVB) is the main therapy for people with vitiligo, who typically receive two or three treatments a week. Some vitiligo patients are reluctant to undergo NB-UVB, due to safety concerns, Dr. Bae noted in the Journal of the American Academy of Dermatology.

In the new study, he and his colleagues reviewed Korean National Health Insurance claims data on 3,678 vitiligo patients who had received fewer than three sessions of NB-UVB phototherapy and 1,839 who had received at least 100 treatments.

The incidence rate for all fracture types was 138.7 per 10,000 person-years for the non-phototherapy group and 105.5 per 10,000 PY for the phototherapy group (hazard ratio, 0.745; P=0.0066). Spinal fracture incidence was 72.3 per 10,000 PY without phototherapy and 45.9 per 10,000 PY with phototherapy (HR, 0.647; P=0.0062).

The incidence rates for hip, wrist and upper arm fractures were numerically lower with phototherapy, but the differences were not statistically significant.

"Sunlight has various wavelengths of light, but the wavelength that effectively synthesizes vitamin D is UVB," Dr. Bae said. "Because narrowband UVB phototherapy removes burning wavelengths, it may produce vitamin D more safely in our skin."

Doctors should reassure vitiligo patients about the safety of NB-UVB phototherapy and encourage them to get treated, he said. "It would be a great pleasure if our research were of practical benefit to both doctors and patients."

He added: "My colleagues and I are exploring drugs that can help patients with vitiligo through big data analysis, and we will announce the results soon. For orphan disorders like vitiligo, drug repositioning would be such a fascinating and valid approach."

The study had no specific funding, and the researchers report no conflicts of interest.

By Anne Harding

SOURCE: https://bit.ly/3myGvxV Journal of the American Academy of Dermatology, online September 10, 2020.

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