Efficacy and Safety of Combined Platelet-Rich Plasma With Fractional Laser for Adult Patients With Vitiligo: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE

Platelet-rich plasma (PRP) is a novel treatment option for vitiligo. It has been reported to be effective in combination with other methods, such as fractional laser. However, there is no consensus on the specific combined use of PRP with fractional laser. Therefore, this meta-analysis assessed the efficacy and safety of this combination regimen compared to control groups for vitiligo.

METHODS

A comprehensive literature search was conducted for relevant randomized controlled trials comparing PRP plus fractional laser with other routine treatments published from inception to January 2025. Data regarding the mean grade of repigmentation, patient's satisfaction score, rate of satisfactory repigmentation or no response, and incidence of side effects were extracted and meta-analyzed using a fixed or randomized model.

RESULTS

Seven studies involving 366 patients were reviewed. The combination of PRP and fractional laser therapy significantly improved the mean grade of repigmentation (mean difference [MD] = 1.58; 95% confidence interval [CI] = 1.08-2.07; p < 0.01) and patients' satisfaction score (MD = 1.87; 95% CI = 0.90-2.83; p = 0.0001), while also reducing the no response rate (risk ratio [RR] = 0.54; 95% CI = 0.32-0.92; p = 0.02), compared with control groups, including monotherapy, topical drug or sun exposure only, and fractional lasers plus narrowband ultraviolet B. Additionally, the incidence of adverse events for combination therapy was comparable to that of control groups (RR = 0.86; 95% CI = 0.69-1.07; p = 0.17).

CONCLUSIONS

This meta-analysis provides evidence supporting the combined use of PRP and fractional laser therapy as a valuable and safe treatment modality for patients with vitiligo, based on its superiority to control groups and comparable rates of side effects. However, more well-designed and large-scale studies are required to confirm it.