Efficacy and tolerability of oral upadacitinib monotherapy in patients with recalcitrant vitiligo

Su, Xinhong; Luo, Renwei; Ruan, Shifan; Zhong, Qingmei; Zhuang, Zhixiong; Xiao, Zhixun; Zhang, Peng; Cheng, Bo; Gong, Ting; Ji, Chao

doi:10.1016/j.jaad.2023.07.1016

Cited by 11 publications

(6 citation statements)

References 5 publications

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“…Finally, a series of 12 patients treated with oral upadacitinib in monotherapy has recently been published, which, in line with the results of studies with other oral iJAKs, showed moderate improvement, especially in the facial area [96].…”

Section: Case Reports and Case Seriessupporting

confidence: 60%

Vitiligo: Pathogenesis and New and Emerging Treatments

Perez-Bootello,

Cova-Martin,

Naharro-Rodriguez

et al. 2023

IJMS

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Vitiligo is a complex disease with a multifactorial nature and a high impact on the quality of life of patients. Although there are multiple therapeutic alternatives, there is currently no fully effective treatment for this disease. In the current era, multiple drugs are being developed for the treatment of autoimmune diseases. This review assesses the available evidence on the pathogenesis of vitiligo, and a comprehensive review of treatments available for vitiligo now and in the near future is provided. This qualitative analysis spans 116 articles. We reviewed the mechanism of action, efficacy and safety data of phototherapy, afamelanotide, cyclosporine, phosphodiesterase 4 inhibitors, trichloroacetic acid, basic fibroblast growth factor, tumor necrosis factor (TNF) inhibitors, secukinumab, pseudocatalase and janus kinase (JAK) inhibitors. At the moment, there is no clearly outstanding option or fully satisfactory treatment for vitiligo, so it is necessary to keep up the development of new drugs as well as the publication of long-term effectiveness and safety data for existing treatments.

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Section: Case Reports and Case Seriessupporting

confidence: 60%

Vitiligo: Pathogenesis and New and Emerging Treatments

Perez-Bootello,

Cova-Martin,

Naharro-Rodriguez

et al. 2023

IJMS

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“…Baricitinib has also been found to promote tyrosinase activity, melanin content, and tyrosinase, tyrosinase-related protein-1 gene expression of melanocytes damaged model in vitro ( 27 ). As an oral selective JAK1 inhibitor, upadacitinib monotherapy caused an average improvement of 38.65% in VASI for 12 refractory patients and ameliorated their quality of life ( 28 ). No serious adverse events were noted in these studies.…”

Section: Jak Inhibitor Therapymentioning

confidence: 99%

Management of the refractory vitiligo patient: current therapeutic strategies and future options

Wang,

Wu,

Chen

et al. 2024

Front. Immunol.

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Vitiligo is an autoimmune disease that leads to disfiguring depigmented lesions of skin and mucosa. Although effective treatments are available for vitiligo, there are still some patients with poor responses to conventional treatment. Refractory vitiligo lesions are mostly located on exposed sites such as acral sites and lips, leading to significant life stress. Understanding the causes of refractory vitiligo and developing targeted treatments are essential to enhance vitiligo outcomes. In this review, we summarized recent treatment approaches and some potential methods for refractory vitiligo. Janus kinase inhibitors have shown efficacy in refractory vitiligo. A variety of surgical interventions and fractional carbon dioxide laser have been widely applied to combination therapies. Furthermore, melanocyte regeneration and activation therapies are potentially effective strategies. Patients with refractory vitiligo should be referred to psychological monitoring and interventions to reduce the potential pathogenic effects of chronic stress. Finally, methods for depigmentation and camouflage may be beneficial in achieving uniform skin color and improved quality of life. Our ultimate focus is to provide alternative options for refractory vitiligo and to bring inspiration to future research.

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“…Upadacitinib is a selective JAK1 inhibitor used to treat atopic dermatitis, rheumatoid arthritis, and ankylosing spondylitis. A case series showed that an average improvement in pigmentation of 51.4% was observed in patients with facial vitiligo and 16.8% improvement in acral vitiligo [120]. In a phase 2b study, upadacitinib achieved the primary endpoint of % change from baseline in F-VASI at week 24, with improvements in both 11 mg (−35.6%) and 22 mg (−34.0%) versus placebo (−14.4%; p value ≤0.01 and p value ≤0.05, respectively).…”

Section: Oral Jak Inhibitorsmentioning

confidence: 99%

Bridging Molecular Mechanism and Clinical Practice in Vitiligo Treatment: An Updated Review

Ju,

Bae

2024

Dermatology

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Background: In recent years, a great advance has been made in the area of pathogenesis of vitiligo and the understanding of vitiligo treatment is also expanding. Summary: Treatment of vitiligo seeks to achieve three goals: cessation of disease progression, regeneration of pigmentation, and prevention of recurrence. To achieve these goals, a number of non-surgical interventions are available that suppress the autoimmune response and regenerate the remaining melanocytes from the reservoir, and optimal treatment outcome can be achieved when each modality is used properly. Key Messages: Our review describes various treatment modalities for vitiligo based on their molecular mechanism of action. Bridging the gap between molecular mechanisms and therapeutic options would be a valuable reference for physicians in clinical practice.

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Efficacy and tolerability of oral upadacitinib monotherapy in patients with recalcitrant vitiligo

Cited by 11 publications

References 5 publications

Vitiligo: Pathogenesis and New and Emerging Treatments

Vitiligo: Pathogenesis and New and Emerging Treatments

Management of the refractory vitiligo patient: current therapeutic strategies and future options

Bridging Molecular Mechanism and Clinical Practice in Vitiligo Treatment: An Updated Review

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