WEDNESDAY, Jan. 22, 2025 -- For adults with severe, active, nonsegmental vitiligo, baricitinib combined with narrowband ultraviolet light B (UV-B) is efficacious compared with placebo, according to a study published online Jan. 22 in JAMA Dermatology.

Julien Seneschal, M.D., Ph.D., from the Hôpital Saint-André in Bordeaux, France, and colleagues examined the efficacy and adverse events of baricitinib combined with narrowband UV-B in adults with severe, active, nonsegmental vitiligo in a multicenter, double-blind, noncomparative randomized clinical trial. Participants were randomly assigned to baricitinib, 4 mg per day, or placebo for 36 weeks, alone for the first 12 weeks and then in combination with narrowband UV-B twice a week from weeks 12 to 36 (37 and 12 patients, respectively).

The researchers found that the mean change in total Vitiligo Area Scoring Index (VASI) at week 36 was −44.8 and −9.2 percent for the baricitinib and placebo groups, respectively. The change with baricitinib was not significantly greater than the threshold for sufficient repigmented surface of 42.9 percent. In post-hoc analyses, at week 36, there was a significant difference for total VASI score in the group receiving baricitinib plus narrowband UV-B versus the group receiving placebo plus narrowband UV-B (−44.8 versus −9.2 percent, respectively). Compared with the placebo group, the baricitinib group had greater improvement in disease activity and quality of life; the number of adverse events did not differ significantly between the groups.

This trial "is a valuable contribution to the growing interest in the use of Janus kinase inhibitors to treat autoimmune conditions and justifies the completion of a larger confirmatory phase 3 trial in the future," the authors write.

Several authors disclosed ties to pharmaceutical companies, including Eli Lilly, which manufactures baricitinib and funded the study.