Vitiligo: Ruxolitinib and Other Oral Treatment Options Beyond Ruxolitinib.
Publication/Presentation Date
10-1-2025
Abstract
BACKGROUND: Vitiligo is a chronic autoimmune disorder marked by the loss of melanocytes, causing depigmented patches across the skin. Affecting up to 2% of the global population, vitiligo presents significant psychological impacts, particularly in those with darker skin types. Current hypotheses attribute its etiology to autoimmune destruction, genetic predisposition, and environmental triggers like trauma and stress.
MATERIALS AND METHODS: A comprehensive review of recent studies was conducted using PubMed and Google Scholar, focusing on systemic treatments for vitiligo, particularly JAK inhibitors (ruxolitinib, upadacitinib, tofacitinib, ritlecitinib, and baricitinib). Eligible studies included trials and case reports on adults with vitiligo evaluating treatment efficacy, safety, and tolerability.
RESULTS: Topical ruxolitinib has achieved the highest efficacy in repigmenting facial and sun-exposed areas, particularly when combined with phototherapy. Emerging evidence supports oral Janus kinase (JAK) inhibitors, especially upadacitinib and tofacitinib, for their repigmenting effects in refractory cases, though side effects like acne and neutropenia warrant monitoring. Limited evidence supports methotrexate and minocycline as adjunct therapies, with minor repigmentation observed.
CONCLUSION: Advances in systemic and topical JAK inhibitors have shown promising repigmentation effects in vitiligo, particularly for localized facial lesions. Ruxolitinib cream, the first FDA-approved therapy, and other JAK inhibitors highlight a growing therapeutic approach, with ongoing trials needed to optimize efficacy and evaluate long-term safety. Combination therapy with phototherapy shows enhanced repigmentation outcomes.
Volume
31
Issue
10
First Page
70276
Last Page
70276
ISSN
1600-0846
Published In/Presented At
Ghani, H., Tan, I. J., Ghofrani, S., Tchack, M., & Rao, B. (2025). Vitiligo: Ruxolitinib and Other Oral Treatment Options Beyond Ruxolitinib. Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI), 31(10), e70276. https://doi.org/10.1111/srt.70276
Disciplines
Education | Medical Education
PubMedID
41117150
Department(s)
Department of Education
Document Type
Article