Recall the clinical trial data on JAK inhibitors for the management of vitiligo

Describe strategies to manage AE associated with JAK inhibitors

Discuss how to utilize JAK inhibitors in clinical practice for the management of vitiligo

Open Up to New Treatments for Vitiligo: Online CME Activity

Overview of the pathophysiology of vitiligo

Report on the key data for JAK inhibitors for the management of vitiligo

Explain tactics to prevent and manage AE with JAK inhibitors


Recognize strategies to optimize care for patients with vitiligo

Not Just Skin Deep: Revealing New Strategies to Manage Vitiligo Online CME Activity

Vitiligo

For patients with active nonsegmental vitiligo (NSV), oral ritlecitinib is effective and well tolerated over 48 weeks, according to a study published online Nov. 9 in the
 
 Journal of the American Academy of Dermatology
 
 .




 Khaled Ezzedine, M.D., Ph.D., from the Hôpital Henri Mondor and Université Paris-Est Créteil, and colleagues examined the efficacy and safety of ritlecitinib in patients with active NSV in a phase 2b trial. A total of 364 patients were randomly assigned to once-daily oral ritlecitinib ± a four-week loading dose (200/50 mg, 100/50 mg), oral ritlecitinib without a loading dose (50 mg, 30 mg, or 10 mg), or placebo for 24 weeks in the dose-ranging period. In a 24-week extension period, 187 patients received ritlecitinib 200/50 mg daily.




 The researchers found that the percentage change from baseline in the Facial-Vitiligo Area Scoring Index differed significantly from placebo for the ritlecitinib 50 mg group with or without a loading dose (–21.2 and –18.5, respectively, versus 2.1) and the ritlecitinib 30 mg group (–14.6 versus 2.1). In the extension period, accelerated improvement was seen after treatment with ritlecitinib 200/50 mg. Across the 48-week treatment, there were no dose-dependent trends observed in treatment-emergent or serious adverse events.




 "This phase 2 trial suggests ritlecitinib is an effective and well tolerated treatment for patients with active NSV," the authors write. "As indicated by data during the extension period, longer treatment duration may be required for optimal repigmentation."




 Several authors disclosed financial ties to pharmaceutical companies, including Pfizer, which manufactures ritlecitinib and funded the study.




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Significant differences seen from placebo in percentage change from baseline in the Facial-Vitiligo Area Scoring Index for 50, 30 mg ritlecitinib

Is Ritlecitinib Effective, Tolerated for Active Nonsegmental Vitiligo?

The U.S. Food and Drug Administration has approved Opzelura (ruxolitinib) as the first topical treatment for vitiligo.




 The 1.5 percent cream is approved for continuous topical use twice daily to affected areas of up to 10 percent of body surface area in patients aged 12 years and older. More than 24 weeks of treatment may be needed for satisfactory patient response.




 The approval was based on results from the TRuE-V clinical trials, in which more than 600 patients were randomly assigned to Opzelura or placebo. At week 24, 30 percent of patients treated with Opzelura achieved ≥75 percent improvement from baseline in the facial Vitiligo Area Scoring Index (F-VASI75) versus 8 to 13 percent of patients treated with placebo. Approximately half of Opzelura-treated patients achieved F-VASI75 at week 52.




 "There have been no FDA-approved therapies available to date and the approval of Opzelura therefore marks a significant milestone," David Rosmarin, M.D., from Tufts Medical Center in Boston, said in a company press release. "I welcome a medical treatment that helps my patients with nonsegmental vitiligo who are interested in potentially reversing the depigmentation caused by their disease."




 Approval was granted to Incyte.




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Opzelura can be used twice daily in patients ages 12 years and older

FDA Approves First Topical Treatment for Vitiligo

For patients with nonsegmental vitiligo with depigmentation covering ≤10 percent of total body surface area, ruxolitinib cream yields clinically meaningful facial and total body repigmentation, according to a study presented at the annual meeting of the American Academy of Dermatology, held from March 25 to 29 in Boston.




 David Rosmarin, M.D., from Tufts Medical Center in Boston, and colleagues randomly assigned patients aged 12 years and older diagnosed with nonsegmental vitiligo with depigmentation covering ≤10 percent total body surface area to receive 1.5 percent ruxolitinib cream or vehicle for 24 weeks in a 2:1 ratio, after which all patients could receive ruxolitinib cream for 52 weeks. Data were included from two phase 3 studies with 221 and 229 patients receiving ruxolitinib cream and 109 and 115 patients receiving vehicle.




 The researchers found that for the primary end point of ≥75 percent improvement in facial Vitiligo Area Scoring Index (VASI), ruxolitinib cream was statistically superior to vehicle at week 24 (29.8/30.9 versus 7.4/11.4 percent, respectively); ruxolitinib cream was also statistically superior for all key secondary end points, including ≥50 percent improvement in total VASI. Among patients who applied ruxolitinib from day 1, increases were seen in responses through week 52. Treatment-related adverse events occurred in 18.6/15.4 percent of those who applied ruxolitinib cream through 52 weeks, most frequently application site acne (5.9/5.3 percent) and application site pruritus (5.0/4.4 percent).




 "Ruxolitinib cream demonstrated clinically meaningful facial and total body repigmentation through 52 weeks in phase 3 studies and was generally well tolerated," the authors write.




 The studies were funded by Incyte Corporation, the manufacturer of ruxolitinib.




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Clinically meaningful improvement reported in facial and total Vitiligo Area Scoring Index with ruxolitinib cream

AAD: Ruxolitinib Beneficial in Nonsegmental Vitiligo

The Facial Vitiligo Area Scoring Index (F-VASI), which uses the fingertip unit (FTU), is precise and reliable for assessing the extent of facial involvement in patients with vitiligo, according to a study published in the February issue of the
 
 Journal of the American Academy of Dermatology
 
 .




 Jung Min Bae, M.D., Ph.D., from The Catholic University of Korea in Suwona, and colleagues developed and validated a practical instrument for facial vitiligo. The ratio of a hand to an FTU was calculated for 98 healthy volunteers to define the FTU. The sum of all FTUs of each vitiligo lesion on the face was measured as the F-VASI. Six raters evaluated 11 patients with facial vitiligo twice two weeks apart in the validation study.




 One hand was measured at 32.1 ± 1.3 FTU, which was highly consistent across age groups, sexes, and races. The researchers found remarkably high accuracy for the F-VASI (concordance correlation coefficient, 0.946), and intrarater reliability was also high (intraclass correlation coefficient, 0.903; interrater reliability, 0.903).




 "The FTU is a practical and precise measurement unit for assessing the extent of facial involvement in patients with vitiligo (F-VASI)," the authors write. "It not only allows for more precise assessments of small focal lesions on the face or genital area but can also complement VASI measurement of widespread vitiligo through proper conversion."




 Several authors disclosed financial ties to the pharmaceutical and health care industries.




 <a class="rm-stats-tracked" href="https://www.jaad.org/article/S0190-9622(21)02082-X/fulltext" target="_blank">
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Facial Vitiligo Area Scoring Index, using the fingertip unit, has high accuracy and intrarater reliability

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