{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:14:02Z","timestamp":1780571642909,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T00:00:00Z","timestamp":1562025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is currently no definitive treatment for vitiligo; various modalities include immune modulators phototherapy and skin camouflage. We investigated the efficacy and safety of topical tacrolimus either as monotherapy or combined therapy in the treatment of vitiligo. Electronic systematic search of the literature was carried out using four major databases. Randomised clinical trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) that reported the use of topical tacrolimus in the treatment of human vitiligo have been included in a systematic review and meta\u2010analysis. Meta\u2010analysis was conducted via RevMan, and risk of bias was assessed through the Cochrane quality assessment tool. The protocol was published through <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>42018112430). A total of 19 studies including 814 patients were included in our systematic review. The random\u2010effects\u2010model meta\u2010analysis of two studies revealed that the tacrolimus and narrowband ultraviolet B (<jats:styled-content style=\"fixed-case\">NB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UVB<\/jats:styled-content>) combination therapy rates is better than <jats:styled-content style=\"fixed-case\">NB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UVB<\/jats:styled-content> alone in inducing &gt;75% repigmentation [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.34 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 01.05\u20131.71), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02]. Tacrolimus and steroids had similar potency in acheiving &gt;75% repigmentation [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.02 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.19\u20135.51), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.98]. Meta\u2010analysis of two studies revealed that the fractional laser and tacrolimus combination therapy is no better than tacrolimus alone in causing &gt;75% repigmentation [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 2.11 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.87\u20135.09), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.10]. Further investigating tacrolimus as mono\u2010 or adjuvant therapy for vitiligo is highly recommended. Combining tacrolimus to other treatment options such as steroids, phototherapy and laser may be superior to using tacrolimus alone.<\/jats:p>","DOI":"10.1111\/ajd.13096","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T05:33:54Z","timestamp":1562132034000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["The efficacy and safety of tacrolimus as mono\u2010 and adjunctive therapy for vitiligo: A systematic review of randomised clinical trials"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3859-7338","authenticated-orcid":false,"given":"Charan Jeet","family":"Arora","sequence":"first","affiliation":[{"name":"Miranda Medical Centre Miranda New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Rafiq","sequence":"additional","affiliation":[{"name":"Department of Learning, Informatics, Management and Ethics (LIME) Karolinska Instiutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Shumack","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Department of Dermatology Royal North Shore Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monisha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Dermatology Liverpool Hospital Sydney New South Wales Australia"},{"name":"Department of Medicine UNSW Sydney New South Wales Australia"},{"name":"The Skin Hospital Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.10.048"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2016.11.013"},{"key":"e_1_2_6_4_1","volume-title":"Autoimmunity in Vitiligo. 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