Child, Progressive Disease, Vitiligo
Conditions
Keywords
Tacrolimus, Dexamethasone, Randomized Controlled Trialy, Children, Vitiligo, Safety, Efficacy, Multicenter Study, VASI Score, IGA Score, Immunosuppressive Therapy
Brief summary
This clinical study aims to compare the safety and effectiveness of two treatments-oral Tacrolimus capsules and Dexamethasone micro-pulse therapy-in children aged 4-12 years with rapidly progressing vitiligo. The study is a multicenter, randomized, controlled trial involving 90 participants, who will be divided equally into two groups. One group will receive daily Tacrolimus, while the other will take Dexamethasone on weekends. Over 24 weeks, doctors will monitor improvements in skin repigmentation, side effects, and overall health through regular check-ups and blood tests. The goal is to determine which treatment better controls disease progression and improves quality of life for children with vitiligo. Key Points: * For children with rapidly spreading vitiligo. * Compares two common medications. * Follows participants for 6 months. * Focuses on safety and effectiveness.
Detailed description
Background: Vitiligo is an autoimmune skin condition causing pigment loss, significantly impacting children's well-being. Current treatments like systemic corticosteroids (e.g., Dexamethasone) carry risks of long-term side effects. Tacrolimus, an immunosuppressant with a safer profile in other pediatric conditions, shows promise but lacks evidence for oral use in vitiligo. This trial addresses this gap by comparing Tacrolimus and Dexamethasone. Study Design: * Multicenter, randomized, controlled trial across 5 hospitals in China. * 90 participants (4-12 years) with rapidly progressing non-segmental vitiligo (VIDA score 4). * Interventions: * Tacrolimus group: 0.1±0.05 mg/kg/day, divided into two doses. * Dexamethasone group: 0.05±0.025 mg/kg/weekend pulse dosing. * Duration: 24 weeks with follow-ups at 4, 8, 12, 16, 20, and 24 weeks. Outcome Measures: * Primary: Proportion achieving ≥50% improvement in Vitiligo Area Scoring Index (VASI 50) at 24 weeks. * Secondary: VASI 75/90 response rates, Investigator Global Assessment (IGA) scores, and safety parameters (blood tests, metabolic panels, adverse events). Statistical Analysis: Data will be analyzed using chi-square tests to compare efficacy and safety between groups (significance: p ≤ 0.05). All analyses adhere to intention-to-treat principles. Ethics & Compliance: Approved by the Ethics Committee of the First Affiliated Hospital of Air Force Medical University. Informed consent is obtained from all participants' guardians.
Interventions
DRUGTacrolimus
Participants receive oral tacrolimus capsules at a dosage of 0.1 ± 0.05 mg/kg per day, divided into two administrations. The treatment duration is 24 weeks. Blood drug concentration is monitored to maintain trough levels between 7-15 ng/mL. Safety assessments include regular blood tests (hematology, liver/kidney function, blood glucose) and adverse event tracking.
DRUGDexamethasone
Participants receive oral dexamethasone tablets at a dosage of 0.05 ± 0.025 mg/kg per day, administered as a single dose on weekends (Saturday and Sunday). The treatment duration is 24 weeks. Safety evaluations include monitoring of blood parameters (hematology, liver/kidney function, blood glucose), weight, and adrenal function (cortisol, ACTH levels).
Sponsors
Xijing Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This is a multicenter, randomized controlled study. Participants are randomly assigned to two groups, receiving tacrolimus or dexamethasone respectively. The study aims to compare the efficacy and safety of the two interventions for treating rapidly progressive vitiligo in children.
Eligibility
Sex/Gender
ALL
Age
4 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Children aged 4-12 years diagnosed with rapidly progressive non-segmental vitiligo (VIDA score ≥4, indicating disease progression within the past 6 weeks). Total body surface area (BSA) affected by vitiligo between 1% and 50%. Guardians provide written informed consent for the child's participation.
Exclusion criteria
* Stable-phase childhood vitiligo. Segmental, mucosal, undetermined, or generalized vitiligo. Systemic immunosuppressive therapy within the past 4 weeks. Known hypersensitivity to tacrolimus, other macrolide drugs, or study drug excipients. Comorbidities precluding oral tacrolimus use (e.g., severe hepatic/renal dysfunction). Obesity or systemic diseases (e.g., tuberculosis, acute/chronic infections, hypertension, congenital cardiovascular disease). Any condition deemed by investigators to increase participant risk or interfere with trial execution.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Achieving VASI 50 Response | 24 weeks | VASI (Vitiligo Area and Severity Index) 50 response is defined as a 50% or greater reduction in VASI score from baseline. Assessment is conducted by trained dermatologists using standardized VASI scoring criteria. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Vitiligo Area and Severity Index (VASI) Score | 24 weeks | Calculate the difference between the VASI score at 24 weeks and the baseline VASI score. This reflects the improvement in vitiligo area and severity over the treatment period. |
| Proportion of Participants Achieving Investigator Global Assessment (IGA) Score Improvement | 24 weeks | Assess participants' IGA scores at 24 weeks. Participants with an IGA score of mild or better (score ≤ 2) are defined as achieving improvement, and the proportion is calculated. |
| Incidence of Treatment-Emergent Adverse Events | Throughout the 24-week treatment period | Record all adverse events (e.g., gastrointestinal symptoms, metabolic abnormalities) occurring during the 24-week treatment period. Calculate the incidence rate and analyze their relationship with the intervention. |
Countries
China
Contacts
Primary ContactZhe Jian, Associate Professor
Outcome results
None listed