title: Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib.
abstract: BACKGROUND
  Existing therapies for vitiligo are limited in efficacy and can be associated with undesirable side effects. Topical Janus kinase inhibitors may offer a new therapeutic option for vitiligo.
  
  
  OBJECTIVE
  We sought to assess the role of topical ruxolitinib 1.5% cream, a Janus kinase inhibitor, in vitiligo treatment.
  
  
  METHODS
  This 20-week, open-label, proof-of-concept trial of twice-daily topical ruxolitinib 1.5% cream was conducted in 12 patients with a minimum of 1% affected body surface area of vitiligo. The primary outcome was percent improvement in Vitiligo Area Scoring Index from baseline to week 20.
  
  
  RESULTS
  Of 12 patients screened, 11 were enrolled and 9 completed the study (54.5% men; mean age, 52 years). Four patients with significant facial involvement at baseline had a 76% improvement in facial Vitiligo Area Scoring Index scores at week 20 (95% confidence interval, 53-99%; P = .001). A 23% improvement in overall Vitiligo Area Scoring Index scores was observed in all enrolled patients at week 20 (95% confidence interval, 4-43%; P = .02). Three of 8 patients responded on body surfaces and 1 of 8 patients responded on acral surfaces. Adverse events were minor, including erythema, hyperpigmentation, and transient acne.
  
  
  CONCLUSIONS
  Limitations of the study include the small sample size and open-label study design.
  
  
  CONCLUSIONS
  Topical ruxolitinib 1.5% cream provided significant repigmentation in facial vitiligo and may offer a valuable new treatment for vitiligo.
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Brooke
authors.initials: B
authors.lastname: Rothstein
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Deep
authors.initials: D
authors.lastname: Joshipura
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Ami
authors.initials: A
authors.lastname: Saraiya
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Rana
authors.initials: R
authors.lastname: Abdat
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Huda
authors.initials: H
authors.lastname: Ashkar
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Yana
authors.initials: Y
authors.lastname: Turkowski
authors.affiliation: Department of Dermatology, Newton Wellesley Hospital, Newton, Massachusetts.
authors.forename: Vaneeta
authors.initials: V
authors.lastname: Sheth
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Victor
authors.initials: V
authors.lastname: Huang
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Shiu Chung
authors.initials: SC
authors.lastname: Au
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Courtney
authors.initials: C
authors.lastname: Kachuk
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Nicole
authors.initials: N
authors.lastname: Dumont
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts; Department of Dermatology, New York Medical College, Valhalla, New York.
authors.forename: Alice B
authors.initials: AB
authors.lastname: Gottlieb
authors.affiliation: Department of Dermatology, Tufts Medical Center, Boston, Massachusetts. Electronic address: DRosmarin@tuftsmedicalcenter.org.
authors.forename: David
authors.initials: D
authors.lastname: Rosmarin
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053612:Janus Kinases; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D010865:Pilot Projects; D011720:Pyrazoles / Q000008:administration & dosage*; D011743:Pyrimidines; D014820:Vitiligo / Q000188:drug therapy*
chemical_list: D009570:Nitriles; D011720:Pyrazoles; D011743:Pyrimidines; C540383:ruxolitinib; D053612:Janus Kinases
keywords: Janus kinase inhibitor; VASI; facial vitiligo; ruxolitinib; topical application; vitiligo