Combining JAK-Inhibitor Baricitinib and Narrow Band UV-B Phototherapy to Treat Vitiligo
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on July 18th, 2025
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Vitiligo is a skin depigmentation disorder caused by melanocyte destruction by immune cells. The condition is traditionally treated with UV-B phototherapy. However, since this process is mediated by both interferon alpha produced by dendritic cells and interleukin-13 from type 2 T-cell response. Medications that interfere with this pathway, like ruxolitinib and baricitinib, can be used to manage the condition. With funding from Eli Lilly, a study was conducted to evaluate the combined effect of baricitinib and UV-B phototherapy in treating vitiligo.
The phase 2 clinical study included 49 participants with an average age of 50 years old who had been diagnosed with active nonsegmental vitiligo affecting no more than 5% of the body surface area. Baseline assessment with the Vitiligo Area Scoring Index (VASI), which evaluates disease severity based on the area of depigmentation, yields an average score of 16. Impact on daily life was also measured using the Dermatology Life Quality Index (DLQI), which showed the cohort mean score to be 4.
The patients were randomly assigned to be treated orally with either placebo or 4 mg of baricitinib per day for 36 weeks. Baricitinib is an immunomodulatory medication that can inhibit the JAK-STAT signaling pathway, which results in the dampening of immune cell activation. Additionally, all of the participants were treated with narrow band UV-B phototherapy twice per week for 24 weeks. UV-B phototherapy is known to reduce skin inflammation and induce the proliferation plus differentiation of melanocytes.
After 36 weeks of treatment, the researchers found that the combination of UV-B phototherapy and baricitinib was effective at skin repigmentation, as indicated by a significant reduction in VASI score. However, this clinical benefit did not result in a parallel effect in life quality as there is no difference in the DLQI score between the two groups. Being a phase 2 study, the small sample size makes it difficult to draw a definitive conclusion on the effectiveness and safety of the combination therapy.
The phase 2 clinical study included 49 participants with an average age of 50 years old who had been diagnosed with active nonsegmental vitiligo affecting no more than 5% of the body surface area. Baseline assessment with the Vitiligo Area Scoring Index (VASI), which evaluates disease severity based on the area of depigmentation, yields an average score of 16. Impact on daily life was also measured using the Dermatology Life Quality Index (DLQI), which showed the cohort mean score to be 4.
The patients were randomly assigned to be treated orally with either placebo or 4 mg of baricitinib per day for 36 weeks. Baricitinib is an immunomodulatory medication that can inhibit the JAK-STAT signaling pathway, which results in the dampening of immune cell activation. Additionally, all of the participants were treated with narrow band UV-B phototherapy twice per week for 24 weeks. UV-B phototherapy is known to reduce skin inflammation and induce the proliferation plus differentiation of melanocytes.
After 36 weeks of treatment, the researchers found that the combination of UV-B phototherapy and baricitinib was effective at skin repigmentation, as indicated by a significant reduction in VASI score. However, this clinical benefit did not result in a parallel effect in life quality as there is no difference in the DLQI score between the two groups. Being a phase 2 study, the small sample size makes it difficult to draw a definitive conclusion on the effectiveness and safety of the combination therapy.