A RECENT clinical trial has shown promising results in treating severe, active vitiligo through a combination of oral medication and phototherapy, offering new hope for managing this challenging condition. Vitiligo, a chronic autoimmune disorder characterized by skin depigmentation, significantly affects quality of life, especially in cases of extensive and active disease.
The study, conducted across four dermatology departments between July 2021 and April 2023, involved 49 adult patients. Participants were randomly assigned in a 3:1 ratio to receive either the experimental oral therapy or a placebo for 36 weeks. Starting at week 12, both groups underwent narrowband UV-B phototherapy twice weekly.
Results revealed a substantial reduction in disease severity for the group receiving the combination therapy. At week 36, patients in the experimental group experienced a mean 44.8% reduction in total Vitiligo Area Scoring Index (VASI) scores, compared to a 9.2% reduction in the placebo group. While the observed repigmentation did not surpass the pre-established threshold of 42.9% considered significant for narrowband UV-B alone, post hoc analysis demonstrated that the combined therapy’s effectiveness was statistically greater than placebo (P = .02).
In addition to physical repigmentation, patients in the experimental group reported greater improvements in quality of life and disease activity compared to the placebo group. Importantly, no significant differences in adverse events were observed between the groups, highlighting the combination therapy’s favorable safety profile.
This proof-of-concept trial offers critical insights into new therapeutic strategies for vitiligo, particularly for patients with severe and progressive disease. The results underline the potential benefits of integrating targeted oral therapies with phototherapy to enhance repigmentation and improve patient outcomes.
Further studies are warranted to confirm these findings and optimize protocols, but this combination approach may represent a significant step forward in vitiligo management.
Reference: Seneschal J et al. Combination of Baricitinib and Phototherapy in Adults With Active Vitiligo. JAMA Dermatol. 2025. doi:10.1001/jamadermatol.2024.5737.
Anaya Malik | AMJ
