3 Oral JAK Inhibitors for Vitiligo 'Running to the Finish Line'

Recent data supporting the use of topical ruxolitinib and oral Janus kinase (JAK) inhibitors for treating vitiligo were presented by Dr. Seemal Desai and Dr. Larry Eichenfield at the 44th Annual Fall Clinical Dermatology Conference.

In the TRuE-V1 and TRuE-V2 studies, for all body regions (excluding face), VASI50 response rates increased steadily through 52 weeks among vitiligo patients treated with ruxolitinib cream only (Weeks 12/24/40/52: 8.7%/20.8%/37.0%/47.7%, respectively; a similar response pattern was observed among patients who crossed over from vehicle after Week 24.

“And it only keeps getting better,” Dr. Desai said. “We keep people on this for 1, up to 2 years, or more.”

Dr. Eichenfield presented data on povorcitinib, upadacitinib, and ritlecitinib. In a Phase 2b trial evaluating oral povorcitinib for vitiligo, Dr. Eichenfield noted continued responses over 52 weeks in most body regions, including the hands and feet; he noted that facial repigmentation was more rapid, but that most nonfacial body regions improved over time. In a Phase 2 randomized, double-blind, dose-ranging study of upadacitinib in adults with nonsegmental vitiligo (NSV), generally dose-dependent responses with higher response in active NSV vs "stable NSV” was observed; responses were not affected by Fitzpatrick phototype, disease duration, or disease severity. Finally, Dr. Eichenfield noted promising results from a Phase 2 study of oral ritlecitinib for vitiligo.

“The message for oral JAKs is there are three that are running to the finish line,” Dr. Eichenfield said. “We will have oral therapies for vitiligo that are FDA approved. I never thought it would happen.”