Vitiligo patients have increased numbers of autoreactive, melanocyte-specific CD8+ T cells in their skin and blood, which are directly responsible for melanocyte destruction. In addition, gene expression in lesional skin from vitiligo patients revealed an IFNγ-specific signature, including the chemokine CXCL10. Experimental data in a mouse model identified a critical role for CXCL10 in both the progression and maintenance of vitiligo, thereby supporting inhibition of CXCL10 as a targeted treatment strategy for vitiligo patients [3]. Since IFNγ signal transduction occurs through JAK1 and 2, JAK inhibitors could lead to blockade of IFNγ signalling and downstream CXCL10 expression. Indeed, a case report published in 2015 showed a treatment success with tofacitinib in a patient with vitiligo [4]. Another case report showed rapid skin repigmentation on oral ruxolitinib in a patient with coexistent vitiligo and alopecia areata [5]. “In this case report, skin repigmentation went hand in hand with a significant reduction of CXCL10,” explained Dr Mehdi Rashighi (Massachusetts Medical School, USA) during his presentation [1].
The latest proof-of-concept study for JAK inhibition in vitiligo was published recently [2]. In this randomised, double-blind, phase 2 study, adult patients with vitiligo were treated with ruxolitinib cream in different doses (0.15% up to 1.5% twice daily). The primary endpoint was the proportion of patients achieving a 50% or higher improvement from baseline in the facial Vitiligo Area Severity Index (F-VASI) at week 24. In the highest dose group, 30.3% of patients achieved this endpoint, a percentage that increased to 51.5% after 52 weeks. At this time, a third of the patients even gained an F-VASI-90 response. “Clearly, the best response was seen with the 1.5% ruxolitinib cream applied twice daily,” Dr Rashighi stated. The tolerability of the cream was good; only acne was seen more frequently than in the vehicle group. Enrolment for a phase 3 trial with this cream is already completed.
“Hopefully, within the next 5-8 years, we will have more therapeutic options in vitiligo,” concluded Dr Rashighi.
- Rashighi M. JAK family inhibitors – In vitiligo. D1T06.3A, EADV 2020 Virtual Congress, 29-31 Oct.
- Rosmarin D, et al. Lancet 2020;396:110-20.
- Rashighi M, et al. Sci Transl Med 2014;6:223ra23.
- Craiglow BG, King BA. JAMA Dermatol 2015;151:1110-2.
- Harris JE, et al. J Am Acad Dermatol 2016;74:370-1.
Posted on
Previous Article
« JAK1 inhibition successful in hidradenitis suppurativa Next Article
Ligelizumab for chronic spontaneous urticaria: a new star on the horizon »
« JAK1 inhibition successful in hidradenitis suppurativa Next Article
Ligelizumab for chronic spontaneous urticaria: a new star on the horizon »
Table of Contents: EADV 2020
Featured articles
Late-Breaking News
Selective IL-23 blocker shows potential in psoriasis treatment
Promising results with nanobody treatment in psoriasis
Light at the end of the tunnel for chronic hand eczema
Epidermolysis bullosa: Novel wound treatment on the horizon
Efficacious non-steroidal topical for psoriasis
Oral JAK 1 inhibitor leads to fast itch relieve and remarkable skin clearance in AD
COVID-19: What Dermatologists Need to Know
Biologic psoriasis treatment and COVID-19 risk: Contradictory results
Much to be learned about COVID-19 and the skin
JAK Inhibitors – A Fascinating Novel Drug Class
JAK inhibitors in AA: re-establishing the immune privilege of hair follicles
JAK1 inhibition successful in hidradenitis suppurativa
Topical JAK inhibition: a novel treatment option for patients with mild-to-moderate AD
Urticaria – What’s new
Chronic inducible urticaria can require some detective work
Chronic spontaneous urticaria: hives, wheals & biomarkers
Ligelizumab for chronic spontaneous urticaria: a new star on the horizon
Infectious Diseases: Novel Developments
Bacterial resistance in skin infections – a challenging threat
Borreliosis: A multifaceted disease
Scabies – A global health challenge
Upcoming Treatments
Meaningful sleep improvement with IL-13 inhibition
Preventing foot odour with zinc oxide coated socks
Baricitinib in AD: Efficacy paired with consistent long-term results
Best of the Posters
Real-world data on brodalumab affirms efficacy and fast onset of action
Heightened risk for psychiatric comorbidities in hidradenitis suppurativa patients
Effects IL-13 blocker improves with longer treatment duration
Related Articles
December 17, 2020
Chronic inducible urticaria can require some detective work
December 17, 2020
Interview past EADV President Prof. Carle Paul
December 17, 2020
Epidermolysis bullosa: Novel wound treatment on the horizon
© 2024 Medicom Medical Publishers. All rights reserved. Terms and Conditions | Privacy Policy