Dr Raj Chovatiya Calls Ruxolitinib Cream a Game Changer for Nonsegmental Vitiligo

In an expert therapeutic update at the 2023 Fall Clinical Dermatology Conference, Raj Chovatiya, MD, PhD, assistant professor of dermatology at Northwestern University's Feinberg School of Medicine, highlights the long-term benefits of topical ruxolitinib 1.5% cream in stopping depigmentation and enhancing repigmentation among patients with nonsegmental vitiligo.

Transcript

Can you highlight some key points from your session on targeted treatment of nonsegmental vitiligo?

If you would have polled me a few years ago, vitiligo would have never really found its way on to a major podium, but it was really my pleasure to talk all about one of our newest treatment options in dermatology in general, and this one particularly, a topical treatment for the treatment of nonsegmental vitiligo.

Just kind of some basics, vitiligo gets broken up into these categories of nonsegmental [and] segmental. Nonsegmental is, by and large, what we see, and we know that we typically treat this topically for patients. We've just been limited based on topical corticosteroids and topical calcineurin inhibitors, which are not necessarily greatly efficacious—they're not targeted, but also can be associated with various cutaneous side effects.

The approval of topical ruxolitinib 1.5% cream has really changed the game when we think about vitiligo treatment. It's targeted for JAK1/2 in particular of the JAK/STAT family, which has a central role in a lot of the interferon gamma–mediated signaling that we think about that is a part of this disease process. Some of the cool data that we reviewed really showed some of the long-term benefits that can occur in terms of stopping depigmentation and enhancing repigmentation in people who have been treated with this topical medication.

Can you elaborate on some of those positive long-term findings?

The way that we studied topical ruxolitinib in the case of vitiligo was looking on the order of months. Typically for diseases like eczema or psoriasis, we think about 3 or 4 months maybe; here we were looking at even more months beyond that. But there's data that actually extends out to a year that suggests to us that the longer you keep treating the better the results are that you're going to see. Even for people that may not necessarily get to where you want to with short- or medium-term treatment, the longer you go, the better people do.

That really teaches us something about vitiligo pathogenesis. [It's] very different than some of our other conditions, and it's probably something that's going to require continuous and chronic therapy in order for people to maintain and achieve the gains they're looking for in terms of repigmentation.

Are these findings specific to any age range?

One of the nice things about topical ruxolitinib 1.5% cream is that it was studied in adolescent and adult populations, meaning that it's not just for individuals 18 and up, [but also] 12 and up. And we know that vitiligo affects not only adults, but can be a huge burden for our adolescent patients particularly going through complex social times, creating a big quality of life impairment. So, I think that having a topical that's a cream that's easy enough to use really opens things up for patients across a very wide span.