Impact of the 2010 Cochrane review 'Interventions for vitiligo'

Article type
Authors
Whitton M1, Batchelor J2, Ezzedine K3, Eleftheriadou V2, Doney E1, Williams H1
1Cochrane Skin Group, United Kingdom
2Centre of Evidence Based Dermatology, Nottingham, United Kingdom
3National Reference Center for Rare Skin Diseases, University Hospital Bordeaux, France
Abstract
Background:
Vitiligo is the most common pigmentary skin disorder affecting 0.5% to 1% of the population worldwide. The disease is characterized by a progressive loss of melanocytes resulting in white patches on the skin, which can affect any part of the body. Although vitiligo has few symptoms, it can cause significant psychological distress, especially for people with darker skin, or where the disease affects exposed areas of the body such as the face. There is a plethora of treatments for vitiligo but no products specifically licensed to treat it, and there is no cure. The 2010 Cochrane review update assessed 57 randomised controlled trials published between 1966 and 2009. In spite of heterogeneity that limited meta-analysis, and the poor methodological quality of the studies, the review has played a vital role in identifying research gaps and informing trial development.

Methods:
We searched databases for citations of the review in publications including guidelines, other reviews, priority setting partnerships, trials and resources for clinicians and patients.

Results:
Citation search results included: (1) guidelines directly influenced by the review: European guidelines on management of vitiligo; guideline on how to design and conduct a vitiligo trial; systematic review on outcome measures; international consensus on core outcomes for vitiligo trials. (2) Prioritisation of research: prioritisation setting partnership. (3) Trials: Hi-Light pilot randomised controlled trial of handheld phototherapy at home (published); National Hi-Light (UK) multicentre randomised trial (National Institute of Health Research funded) (start June 2014); feasibility study of psychological interventions (in preparation). (4) Healthcare impact: clinical knowledge summaries.

Conclusions:
This review has contributed to the prioritisation of vitiligo research topics, informed the generation of guidelines, including the European Dermatology Forum Guideline on Vitiligo, Guidelines for designing and reporting clinical trials in vitiligo and stimulated the development of vitiligo trials.