LONGER topical JAK inhibitor treatment was associated with greater vitiligo improvement in a diverse real-world cohort.
The retrospective study included 120 patients treated for vitiligo at a Southern California academic dermatology center between April 2018 and April 2024. All patients had at least two dermatology visits, recorded Vitiligo Area Scoring Index (VASI) measurements, documented insurance information, and current or previous topical JAK inhibitor treatment.
The cohort included 41 Asian patients, 20 Hispanic patients, and 59 White patients. Researchers assessed associations between demographic and clinical characteristics and three outcomes: VASI improvement, combined topical JAK inhibitor and narrowband UVB phototherapy use, and insurance approval.
Overall, 37 patients experienced VASI improvement, defined as any reduction between their first and most recent recorded scores. Patients who improved had received treatment for a median of 11 months, compared with 7 months among those without improvement.
After adjustment for age, sex, ethnicity, Fitzpatrick Skin Type, vitiligo classification, dual therapy, and treatment duration, each additional month of treatment increased the odds of VASI improvement by 11% (adjusted odds ratio [aOR]: 1.11; 95% confidence interval [CI]: 1.04–1.20).
Half of Hispanic patients improved, compared with 27% of non-Hispanic patients. Non-Hispanic ethnicity was associated with 69% lower adjusted odds of improvement (aOR: 0.307; 95% CI: 0.099–0.912).
However, this association requires cautious interpretation. Only 20 Hispanic patients were included, and localized vitiligo was more common within this group. Although the analysis adjusted for vitiligo classification, residual confounding could not be excluded.
Dual therapy was used by 88 patients but was not independently associated with VASI improvement. Segmental vitiligo was associated with lower odds of receiving dual therapy, although only five patients had this subtype.
Among the 10 topical JAK inhibitor prescription denials, six involved publicly insured patients. By comparison, publicly insured patients accounted for 25 of the 110 approvals, indicating a disparity in treatment access.
The single center design, small subgroups, variable clinician scoring, and definition of improvement as any VASI reduction limit the findings. Nevertheless, the results support counseling patients that repigmentation may require sustained treatment and highlight the need for larger, standardized studies across underrepresented populations.
Reference
Rizwi H et al. Demographic factors associated with response to topical Jak inhibitors in a diverse vitiligo cohort. JID Innovations. 2026;6(6):100520.
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