TOPLINE:

In a phase 2 study, adding narrow-band UVB phototherapy (NB-UVB) resulted in meaningful repigmentation through week 48 without new safety concerns in patients with nonsegmental vitiligo who did not have an adequate response to topical ruxolitinib at week 12.

METHODOLOGY:

• Researchers conducted an open-label phase 2 trial involving 55 patients (median age, 51 years; range, 15-83; 50.9% men) with nonsegmental vitiligo and depigmented areas affecting less than 10% total body surface area, treated with 1.5% ruxolitinib cream applied twice daily to affected areas.
• Most patients had Fitzpatrick skin types II (20.0%), III (30.9%), or IV (20.0%).
• At week 12, 35 (63.6%) of participants had less than 25% improvement from baseline in total Vitiligo Area Scoring Index (T-VASI) and started NB-UVB treatment; 26 completed combination treatment through week 48
• The primary endpoint was change in T-VASI from baseline at week 48.

TAKEAWAY:

• Among the patients who received combination treatment, the mean percentage change in T-VASI was -50.4% at week 48 compared with -7.9 at week 12. T-VASI50 and T-VASI75 response rates increased from 0% at week 12 to 57.7% and 19.2%, respectively, at week 48; 7.7% patients achieved 90% improvement in T-VASI at week 48.
• Overall, the mean change in facial VASI (F-VASI) at week 12 was -32.4 from baseline. After NB-UVB was added, mean F-VASI improved to -85.6% at week 48. F-VASI50, F-VASI75, and F-VASI90 response rates increased from 31.4%, 14.3%, and 0% respectively, at 12 weeks to 96.2%, 84.6%, and 53.8%, respectively, at 48 weeks.
• Plasma trough ruxolitinib concentrations remained low and were not meaningfully altered by NB-UVB.
• Treatment‑emergent adverse events (TEAEs) were common (54.5% overall, 45% on ruxolitinib alone, and 60% with combination treatment) but were mostly mild or moderate; no treatment‑related serious AEs or TEAEs grade 3 or above were reported.

IN PRACTICE:

“Patients who did not achieve T-VASI25 after 12 weeks of ruxolitinib cream monotherapy experienced improvement in disease control when they added NB-UVB phototherapy through Week 48, with many patients achieving meaningful improvements in body and facial repigmentation,” the authors wrote. “Combination therapy was well tolerated, and no new safety concerns were identified,” they added.

SOURCE:

The study was led by Amit G. Pandya, MD, Palo Alto Foundation Medical Group, Sunnyvale, California, and was published online on December 10 in the Journal of Investigative Dermatology.

LIMITATIONS:

Study limitations included selection bias and the lack of direct comparison between monotherapy and combination treatment. Also, add-on NB-UVB was not evaluated from day 1.

DISCLOSURES:

The study was funded by Incyte Corporation. Pandya and several other authors reported receiving consulting fees, honoraria, investigator fees, and speaker fees from many pharmaceutical companies, including Incyte, AVITA, Clinuvel, Boehringer Ingelheim, Lilly, Pfizer, Sun Pharma, Thalocan, Villaris, Vimela, VYNE, and WCG. Two authors disclosed being employees and shareholders in Incyte. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.