Tacrolimus for the Treatment of Adults with Psoriasis or Vitiligo: A Review of the Clinical and Cost-Effectiveness

Key Message

The evidence identified in this report was limited by methodological quality and was heterogeneous regarding patient population and comparators. However, this evidence consistently suggested that tacrolimus demonstrated clinical effectiveness for the treatment of different manifestations of adult psoriasis and adult vitiligo. Evidence from randomized controlled trials suggested that topical tacrolimus was superior to topical pine tar for head and face plaque psoriasis, and demonstrated similar efficacy to topical calcipotriol for chronic plaque psoriasis. For adult vitiligo, randomized controlled trials of fewer than 40 patients did not identify a significant difference between topical tacrolimus and topical pimecrolimus, or topical mometasone furoate in outcomes of repigmentation. One randomized controlled trial of 72 vitiligo lesions also supported the use of topical tacrolimus for prevention of depigmentation of successfully treated lesions. While adverse events of topical tacrolimus in psoriasis patients were not well documented in the identified evidence, the adverse event observations for adult vitiligo patients were consistent and tacrolimus was regarded as safe by study authors. No evidence regarding the cost-effectiveness of tacrolimus for adult psoriasis or adult vitiligo was identified. Additional high quality clinical trials are required to provide definitive conclusions regarding the clinical efficacy and safety of tacrolimus for adult psoriasis and adult vitiligo patients.