The efficacy of afamelanotide and narrowband UV-B phototherapy for repigmentation of vitiligo.

Abstract

BACKGROUND:

Vitiligo is characterized by depigmented patches of skin due to loss of cutaneous melanocytes. Many recent studies have demonstrated defects in the melanocortin system in patients with vitiligo, including decreased circulating and lesional skin levels of α-melanocyte-stimulating hormone (α-MSH). Afamelanotide is a potent and longer-lasting synthetic analogue of naturally occurring α-MSH.

OBSERVATIONS:

We describe the preliminary results of 4 patients with generalized vitiligo who developed repigmentation using afamelanotide in combination with narrowband UV-B (NB-UV-B) phototherapy. Patients were treated 3 times weekly with NB-UV-B and starting in the second month received a series of 4 monthly implants containing 16 mg of afamelanotide. Afamelanotide induced faster and deeper repigmentation in each case. All patients experienced follicular and confluent areas of repigmentation within 2 days to 4 weeks after the initial implant, which progressed significantly throughout treatment. All patients experienced diffuse hyperpigmentation.

CONCLUSIONS:

We propose that afamelanotide represents a novel and potentially effective treatment for vitiligo. The combined therapy of NB-UV-B and afamelanotide appears to promote melanoblast differentiation, proliferation, and eumelanogenesis. Further studies are necessary to confirm these observations.

• Authors: Pearl E Grimes, Iltefat Hamzavi, Mark Lebwohl, Jean Paul Ortonne, Henry W Lim
• Journal: JAMA dermatology (JAMA Dermatol) Vol. 149 Issue 1 Pg. 68-73 (Jan 2013) ISSN: 2168-6084 [Electronic] United States
• PMID: 23407924 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• alpha-MSH
• afamelanotide

Topics

• Adult
• Cell Differentiation (drug effects, radiation effects)
• Cell Proliferation (drug effects, radiation effects)
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Humans
• Melanocytes (metabolism)
• Middle Aged
• Skin Pigmentation (drug effects, radiation effects)
• Time Factors
• Treatment Outcome
• Ultraviolet Therapy (methods)
• Vitiligo (pathology, therapy)
• alpha-MSH (analogs & derivatives, therapeutic use)