New Analysis Provides Evidence-based Recommendations for Vitiligo in Pediatric Patients

03/14/2024

A recent review of nearly 60 studies provides evidence-based recommendations for young patients with vitiligo.

A new consensus statement published in JAMA Dermatology provided evidence-based expert recommendations for the treatment of vitiligo in pediatric, adolescent, and young adult patients. 

The authors undertook a rigorous examination of existing literature and expert consensus, aiming to address the unique challenges presented by this dermatological condition. The targeted studies published in English containing primary data relevant to pediatric vitiligo. Articles meeting specific criteria underwent thorough evaluation based on established frameworks for grading strength of evidence and recommendation levels.

The sample ended up at 59 studies, and 42 recommendations were made across the studies that were included. Specifically, topical corticosteroids, topical calcineurin inhibitors, and topical Janus kinase (JAK) inhibitors were reported as pivotal components of frontline therapy, supported by robust evidence and expert consensus. The authors made careful recommendations regarding dosage, duration, and age-appropriate usage of therapeutic agents. Notably, topical calcineurin inhibitors were endorsed for twice-daily application. They also were advised regarding the use of topical corticosteroids due to the risk of atrophy. Off-label use of topical ruxolitinib, 1.5%, cream was identified as an evidence-based first-line therapy for nonsegmental vitiligo in patients under the age of 12.

"Evidence supports the use of topical calcineurin inhibitors, topical corticosteroids, and topical JAK inhibitors as effective therapeutics for vitiligo in pediatric, adolescent, and young adult patients, with specific decisions on choice of agent based on factors such as site location, body surface area, and age."

Source: Renert-Yuval Y, et al. Expert Recommendations on Use of Topical Therapeutics for Vitiligo in Pediatric, Adolescent, and Young Adult Patients. JAMA Dermatol. 2024;doi:10.1001/jamadermatol.2024.0021

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