From the Guidelines
The most effective treatment for vitiligo is the combination of intradermal platelet-rich plasma (PRP) injection and narrowband ultraviolet B (NB-UVB) phototherapy, which has been shown to significantly improve repigmentation and shorten the duration of follow-up. This treatment approach has been demonstrated to be simple, safe, tolerable, and cost-effective, with a significant improvement in repigmentation compared to NB-UVB alone or excimer laser alone 1. The combination of PRP and NB-UVB has been shown to result in excellent response (75%–100% repigmentation) in 34.6% of patients, and good response (50%–75% repigmentation) in 50% of patients, with no side effects reported 1.
Key benefits of this treatment approach include:
- Significant improvement in repigmentation
- Shortened duration of follow-up
- Simple, safe, and tolerable procedure
- Cost-effective
- No side effects reported
The use of PRP in combination with NB-UVB or excimer laser phototherapy has been shown to increase the efficacy of these treatments, with PRP enhancing the impact of phototherapy and improving the overall result 1. This treatment approach is a promising development in the management of vitiligo, and early intervention is crucial for better treatment outcomes.
Some of the key findings from the study include:
- The combination group had higher repigmentation compared to NB-UVB alone or excimer laser alone
- Excellent response (75%–100% repigmentation) was observed in 34.6% of patients in the combination group
- Good response (50%–75% repigmentation) was observed in 50% of patients in the combination group
- No side effects were reported in any of the groups 1.
From the FDA Drug Label
OPZELURA is a Janus kinase (JAK) inhibitor indicated for: ... the topical treatment of nonsegmental vitiligo in adult and pediatric patients 12 years of age and older. (1.2) In nonsegmental vitiligo, the most common adverse reactions (incidence ≥ 1%) are application site acne, application site pruritus, nasopharyngitis, headache, urinary tract infection, application site erythema, and pyrexia. (6) Apply a thin layer twice daily to affected areas of up to 10% body surface area. (2.3)
The latest development in vitiligo is the topical treatment of nonsegmental vitiligo using ruxolitinib cream (OPZELURA), which is a Janus kinase (JAK) inhibitor. The treatment involves applying a thin layer of the cream twice daily to affected areas of up to 10% body surface area. Common adverse reactions include application site acne, application site pruritus, and nasopharyngitis 2.
From the Research
Latest Developments in Vitiligo Treatment
- Recent studies have explored the use of Janus kinase (JAK) inhibitors, such as ruxolitinib and tofacitinib, in the treatment of vitiligo 3, 4, 5.
- These inhibitors have shown promise in providing significant repigmentation in facial vitiligo and may offer a valuable new treatment option for patients with this condition 3.
- Novel drug delivery systems, including nanotechnology-based approaches, are also being developed to improve the stability, penetration, and targeted delivery of drugs for vitiligo treatment 6.
- Other emerging therapies include cell-based approaches, such as melanocyte-keratinocyte transplantation, and the use of phytoconstituents with antioxidant, anti-inflammatory, and immunomodulatory properties 6, 7.
- Combination therapies, such as tofacitinib combined with narrowband ultraviolet B phototherapy, have also shown effectiveness and safety in treating refractory vitiligo 4.
- The role of light exposure in conjunction with JAK inhibitors has been highlighted, with some studies suggesting that light exposure is necessary for stimulation of melanocyte regeneration 5.
Therapeutic Targets and Treatment Approaches
- The pathophysiology of vitiligo is complex and involves oxidative stress, autoimmune mechanisms, and melanocyte apoptosis 6, 7.
- Molecular-targeted therapies, including those targeting cytokine and signaling pathways, are being investigated as potential treatments for vitiligo 7.
- The use of JAK inhibitors, such as tofacitinib, has been shown to inhibit the autoimmune response in vitiligo, but may require concomitant light exposure for repigmentation to occur 5.
- Novel drug delivery systems and combination therapies are being developed to improve treatment outcomes and reduce side effects in vitiligo patients 6, 4.