Baricitinib is Effective in Treating Progressing Vitiligo in vivo and in vitro

Abstract

Objective To evaluate the clinical efficacy and safety of baricitinib, a Janus kinase (JAK) inhibitor, in treating patient with progressing vitiligo, and to further explore the regulation of baricitinib on melanocytes (MCs) in vitro. Methods Four patients with progressing vitiligo were treated with oral baricitinib for a total of 12 weeks. MCs were cultured in vitro and irradiated by high-dose ultraviolet B (UVB, 150mJ/cm2) to make an MC damaged model (MC-Ds). Baricitinib was added at a final concentration of 25 μM. Dopamine staining and NaOH method were used to measure the tyrosinase activity and melanin level, respectively, real-time quantitative polymerase chain reaction (RT-qPCR) was used to measure the mRNA levels of tyrosinase (TYR), tyrosinase-related protein-1 (TRP-1). Results Significant re-pigmentation was observed in the week 12 without obvious side effects. Depigmentation occurred in 2 patients at the 3-month follow-up. Laboratory research found that higher doses of UVB irradiation (150mJ/cm2) could decrease melanin content of MCs, baricitinib (25 μM) could significantly promote tyrosinase activity, melanin content, and TYR, TRP-1 gene expression of MC-Ds. Conclusion Our preliminary study showed that baricitinib was effective and safe in treating progressing vitiligo. Baricitinib could promote tyrosinase activity, melanin content and TYR, TRP1 gene expression of MC-Ds in vitro.

A systematic review of case series and clinical trials investigating systemic oral or injectable therapies for the treatment of vitiligo

“…Several studies have shown that baricitinib is effective in treating various skin conditions such as atopic dermatitis (AD), alopecia areata (AA), psoriasis, and vitiligo 55 . The results of our study have also shown the significant effectiveness of this drug in treating vitiligo 56 …”

“…A total of 12 patients participated in these studies. The first study demonstrated that baricitinib was both effective and safe in treating progressing vitiligo (with a significance level of p < 0.05) 35 . In a study involving eight vitiligo patients, baricitinib was administered and their progress was monitored at 3 and 6 months.…”

“…55 The results of our study have also shown the significant effectiveness of this drug in treating vitiligo. 56 Antioxidants are another effective treatment for vitiligo. In recent times, there has been an increasing interest in examining the impact of oxidative stress in vitiligo by exploring different antioxidant markers.…”

“…The first study demonstrated that baricitinib was both effective and safe in treating progressing vitiligo (with a significance level of p < 0.05). 35 In a study involving eight vitiligo patients, baricitinib was administered and their progress was monitored at 3 and 6 months. The study found that after 3 and 6 months of treatment, the significant efficiency was 35.3% and 55.9%, respectively, and the total effective rate was 67.6% and 73.5%, respectively.…”

Excellent Repigmentation of Generalized Vitiligo with Oral Baricitinib Combined with NB-UVB Phototherapy

“…In a retrospective study, Liu et al 7 reported that skin exposure to ultraviolet light appears to be required to achieve repigmentation using JAK inhibitors as evidenced by increased JAK1 levels in vitiligo patients that were downregulated after NBUVB treatment. 8 Recently, Dong et al 10 found that in vitro baricitinib could promote tyrosinase activity, melanin content and tyrosinase, tyrosinase-related protein-1 gene expression of melanocytes damaged model, which will be contributed to repigmentation of vitiligo.…”