Zhou Bin, Gui Jiachen, Wang Tao, Li Zhimin, Hu Wenzhi, Zhang Yue, Li Qiang
Graduate School, Hebei North University, Zhangjiakou, People's Republic of China.
Department of Dermatology, Air Force Medical Center, PLA, Beijing, People's Republic of China.
Clin Cosmet Investig Dermatol. 2024 Dec 18;17:2933-2944. doi: 10.2147/CCID.S501688. eCollection 2024.
Vitiligo is a chronic autoimmune disease manifested by depigmented patches of skin devoid of melanocytes. Baricitinib, a JAK inhibitor selectively targeting JAK1/2, has shown preliminary efficacy for vitiligo. We aimed to assess the efficacy and tolerability of combination therapy with baricitinib and narrowband UV-B (NB-UVB) to treat active nonsegmental vitiligo (NSV).
We formed a combination group of 52 patients with NSV receiving baricitinib and NB-UVB irradiation, and a control group of 49 patients with NSV receiving oral mini-pulse (OMP) methylprednisolone and NB-UVB irradiation. Efficacy analysis was conducted for the 6-month period. Six months after the last treatment, the recurrence rates were investigated through follow-up.
From the first month, the mean total vitiligo area scoring index (VASI) score was significantly reduced in the combination group when compared to that in the control group. Starting on the fourth month, the overall response rates (ORRs) were significantly higher in the combination group than in the control group (=0.034). By the sixth month, the ORRs reached 86.5% in the combination group, whereas they reached 67.3% in the control group (=0.022). The serum levels of IFN-γ and CXCL10 in the combination group decreased from 38.52±5.98 pg/mL and 976.67±150.57 pg/mL at baseline to 26.46±5.93 pg/mL and 704.14±103.38 pg/mL at the 6-month juncture, respectively (<0.001). Moreover, we found that there was no significant difference in recurrence rates within 6 months after stopping treatment in both groups. Three patients (5.8%) in the combination group reported developing itchy skin during the first month of treatment period, and one patient (1.9%) developed erythema; no other serious adverse events occurred.
Our observations suggest that the combination therapy with baricitinib and NB-UVB is a promising strategy against NSV. Patients tolerated the treatment well without serious AEs, these results expand treatment options for vitiligo patients, warranting larger clinical trials.
白癜风是一种慢性自身免疫性疾病，表现为皮肤出现无黑素细胞的色素脱失斑。巴瑞替尼是一种选择性靶向JAK1/2的JAK抑制剂，已显示出对白癜风的初步疗效。我们旨在评估巴瑞替尼与窄谱中波紫外线（NB-UVB）联合治疗活动性非节段性白癜风（NSV）的疗效和耐受性。
我们组建了一个由52例接受巴瑞替尼和NB-UVB照射的NSV患者组成的联合治疗组，以及一个由49例接受口服小剂量脉冲（OMP）甲基泼尼松龙和NB-UVB照射的NSV患者组成的对照组。进行为期6个月的疗效分析。在最后一次治疗6个月后，通过随访调查复发率。
从第一个月起，联合治疗组的白癜风总面积评分指数（VASI）平均得分与对照组相比显著降低。从第四个月开始，联合治疗组的总体缓解率（ORR）显著高于对照组（=0.034）。到第六个月时，联合治疗组的ORR达到86.5%，而对照组为67.3%（=0.022）。联合治疗组的血清IFN-γ和CXCL10水平分别从基线时的38.52±5.98 pg/mL和976.67±150.57 pg/mL降至6个月时的26.46±5.93 pg/mL和704.14±103.38 pg/mL（<0.001）。此外，我们发现两组在停药后6个月内的复发率没有显著差异。联合治疗组有3例患者（5.8%）在治疗的第一个月报告出现皮肤瘙痒，1例患者（1.9%）出现红斑；未发生其他严重不良事件。
我们的观察结果表明，巴瑞替尼与NB-UVB联合治疗是一种有前景的NSV治疗策略。患者对该治疗耐受性良好，未出现严重不良事件，这些结果扩展了白癜风患者的治疗选择，值得进行更大规模的临床试验。
