27568 Maintenance of repigmentation after discontinuation of ruxolitinib cream in patients with vitiligo
Rosmarin D, Pandya AG, Grimes P, Lebwohl M, Gottlieb AB, Hamzavi I, Butler K, Kuo F, Wei S, Rumberger B, and Harris JE. 27568 Maintenance of repigmentation after discontinuation of ruxolitinib cream in patients with vitiligo. J Am Acad Dermatol 2021; 85(3):AB36.
J Am Acad Dermatol
Treatment with ruxolitinib cream (Janus kinase [JAK] 1/JAK2 inhibitor) in adult patients with vitiligo resulted in substantial repigmentation over 52 weeks in a phase 2 dose-ranging study (NCT03099304). We assessed maintenance of repigmentation among responders from the phase 2 study following ruxolitinib discontinuation after 104 weeks of treatment. Patients initially randomized to ruxolitinib cream (1.5% twice daily [BID], 1.5% once daily [QD], 0.5% QD, or 0.15% QD) with evidence of facial repigmentation at Week 24 who completed ≥1 follow-up visit 1, 3, or 6 months after an additional 52 weeks of 1.5% ruxolitinib cream BID monotherapy (Weeks 52-104) were analyzed. Loss of repigmentation was defined as an increase in Vitiligo Area Severity Index score during the last follow-up visit vs Week 104 on ruxolitinib cream. Sixteen patients were included in the analysis (1.5% BID, n = 3; 1.5% QD, n = 5; 0.5% QD, n = 3; 0.15% QD, n = 5 [including 2 patients rerandomized to 1.5% BID/0.5% QD after Week 24]). Four patients (25.0%; 1.5% QD, n = 1; 0.5% QD, n = 1; 0.15% QD, n = 2) had repigmentation loss over 1-6 months of follow-up; no patients from the 1.5% ruxolitinib BID treatment group (with 2 years’ exposure) experienced repigmentation loss. There were no significant differences in baseline serum levels of chemokine (C-X-C motif) ligand (CXCL) 9, CXCL10, or interleukin-15 in patients who experienced loss vs maintenance of repigmentation after ruxolitinib cream discontinuation. This exploratory analysis suggests that repigmentation with ruxolitinib cream monotherapy may be maintained postdiscontinuation; larger follow-up studies are required to confirm these findings.