Ruxolitinib cream helps with skin repigmentation in those who had been diagnosed with vitiligo
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 21st, 2022
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The skin depigmentation of vitiligo is caused by the destruction of melanocytes by CD8+ T cells. These lymphocytes are recruited by the Interferon-γ-driven overstimulation of the JAK-STAT pathway at the affected sites. A previous stage II clinical trial had reported that the JAK-inhibiting agent, Ruxolitinib, can help increase the rate of skin repigmentation. The result from the follow-up phase III trial had been released to provide more insight on the efficacy of the ruxolitinib cream.
The paper included study from 2 cohorts of a total sample size of 674 patients older than the age of 12 years old, who had been diagnosed with nonsegmental vitiligo. The trials include patients who have has a minimum score of 0.5 on the 0-to-3 Facial Vitiligo Area Scoring Index (FVASI) and a minimum of 3 on the 0-to-100 Total Vitiligo Area Scoring Index (TVASI) - the score is correlated with severity for both of these scales. Patients were randomly assigned to receive either 1.5% ruxolitinib or vehicle control cream, and they were instructed to topically apply the cream to the affected area on the body and face for 24 weeks. Using the FVASI75 response - 75% decrease in FVASI score - as the primary endpoint, the study found that ruxolitinib has a 2.7 to 4 times higher efficacy than the placebo. In addition, the cream is 3.5 to 4.1 times more effective at reducing the whole body total VASI score by 50% and they experience a significant decrease in vitiligo noticeability. Overall, acne and pruritus at the application site is the most commonly reported side effect. Approximately 5% of those who receive ruxolitinib experience these adverse reactions, twice as often of those who receive the vehicle control cream.
The paper included study from 2 cohorts of a total sample size of 674 patients older than the age of 12 years old, who had been diagnosed with nonsegmental vitiligo. The trials include patients who have has a minimum score of 0.5 on the 0-to-3 Facial Vitiligo Area Scoring Index (FVASI) and a minimum of 3 on the 0-to-100 Total Vitiligo Area Scoring Index (TVASI) - the score is correlated with severity for both of these scales. Patients were randomly assigned to receive either 1.5% ruxolitinib or vehicle control cream, and they were instructed to topically apply the cream to the affected area on the body and face for 24 weeks. Using the FVASI75 response - 75% decrease in FVASI score - as the primary endpoint, the study found that ruxolitinib has a 2.7 to 4 times higher efficacy than the placebo. In addition, the cream is 3.5 to 4.1 times more effective at reducing the whole body total VASI score by 50% and they experience a significant decrease in vitiligo noticeability. Overall, acne and pruritus at the application site is the most commonly reported side effect. Approximately 5% of those who receive ruxolitinib experience these adverse reactions, twice as often of those who receive the vehicle control cream.