The Effectiveness of Home-Based Phototherapy in Vitiligo: A Systematic Review and Meta-Analysis.

Background Phototherapy with narrowband ultraviolet B (UVB) is an effective treatment for vitiligo. However, it requires frequent in‐office visits. Self‐administered home‐based UVB (HBUVB) therapy with a handheld or panel device is an alternative that has received limited research attention. The purpose of this systematic review and meta‐analysis is to evaluate the effectiveness and safety of HBUVB in the treatment of vitiligo compared to in‐office UVB (IOUVB). Methods Searches were conducted on Medline, Cochrane and Embase from inception until 4th of August, 2024. Studies with primary data of patients being treated with a hand‐held UVB device were included in this study. Efficacy as measured in number of patients achieving > 50% or > 75% repigmentation was the primary study outcome. Secondary outcomes analyzed were cost, adverse events and adherence. Results Eighteen studies were included with a total of 1341 vitiligo patients. Of these, four studies (148 HBUVB and 143 IOUVB) could be used for the meta‐analysis. HBUVB was not inferior to IOUVB at achieving > 50% (OR 1.04, 95% CI 0.58–1.87) and > 75% repigmentation (OR 1.26, 95% CI 0.65–2.42). Home‐based UVB was not associated with an increase in risk for either erythema or burning sensations when compared to IOUVB. There was a 14% lower rate of discontinuation amongst patients using HBUVB. Conclusions and Significance/Impact Home‐based UVB therapy is not inferior to in‐office UVB therapy in efficacy or rate of adverse events and demonstrates favourable treatment adherence. This meta‐analysis provides evidence supporting HBUVB as a safe and effective alternative to IOUVB in patients with vitiligo. Trial Registration PROSPERO registration number: (CRD42023478123)