27636 Addition of narrow-band ultraviolet light B phototherapy to ruxolitinib cream in patients with vitiligo
Pandya AG, Harris JE, Lebwohl M, Hamzavi I, Butler K, Kuo F, Wei S, and Rosmarin D. 27636 Addition of narrow-band ultraviolet light B phototherapy to ruxolitinib cream in patients with vitiligo. J Am Acad Dermatol 2021; 85(3):AB158.
J Am Acad Dermatol
Previous reports with Janus kinase (JAK) inhibitors have suggested additional therapeutic benefit with concomitant phototherapy in patients with vitiligo. In a phase 2, randomized, dose-ranging study in adult patients with vitiligo (NCT03099304), ruxolitinib cream, a JAK1/JAK2 inhibitor, was associated with substantial repigmentation for up to 52 weeks of treatment as assessed by ≥50% improvement in facial and total Vitiligo Area Scoring Index (F-VASI50 and T-VASI50). After Week 52, patients were allowed to add narrow-band ultraviolet-B (NB-UVB) therapy while continuing open-label treatment with twice-daily 1.5% ruxolitinib cream. Nineteen patients (mean age, 47 years) received add-on NB-UVB for ≥12 weeks (mean [range] duration, 40 [15–51] weeks) at various frequencies based on investigator site’s standard phototherapy protocol, most commonly 3 times/week (n = 9). Only 4 patients (21%) had adverse events (AEs; all grade 1/2 in severity) after receiving add-on NB-UVB, and no AEs were related to treatment. No AEs related to skin application site reaction, skin malignancies, or laboratory abnormalities were reported. All 19 patients who received ruxolitinib cream with add-on phototherapy experienced improvement in repigmentation (before vs after add-on NB-UVB: F-VASI75, 42% vs 68%; F-VASI90, 21% vs 58%; T-VASI50, 42% vs 68%). The benefit was more apparent in the 12 patients who had not achieved F-VASI50 at Week 24. In summary, the addition of phototherapy to ruxolitinib cream in patients with vitiligo was well tolerated and demonstrated further improvement in repigmentation. Larger studies are needed to confirm these findings.