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Use of Ruxolitinib in Vitiligo Treatment

Opinion
Video

Chesahna Kindred, MD, MBA, FAAD, and Renata Block, PA-C, describe how ruxolitinib works differently from other topicals traditionally used in the treatment of vitiligo.

Heather Woolery-Lloyd, MD: Now, we talked a little bit about the new FDA-approved treatment for vitiligo, and we know that ruxolitinib was approved in 2022 as the first at-home treatment for nonsegmental vitiligo. [Dr Kindred], can you describe how ruxolitinib works differently [from] all these other topicals that we’ve been discussing that have been traditionally used for vitiligo?

Chesahna Kindred, MD, MBA, FAAD: Different in a few ways. One is just how it works. The mechanism of action is a JAK [Janus kinase] inhibitor, so it’s a bit more specific in reducing inflammation. Cortisones just block all inflammation and not with precision. We also aren’t worried about that dichotomy between a cortisone that can be more effective and a calcineurin inhibitor, not so much. I’m fine if [ruxolitinib is] on normal skin. I’m not worried about atrophy, but we see great results in our office with ruxolitinib. It’s become my go-to because I had to pick between effectiveness and atrophy, which has been the case up until now. Obviously, what’s different is we’re not we’re worried about the impracticality of an in-office treatment.

Heather Woolery-Lloyd, MD: Yes, because this is something that patients can do at home. We’ve talked a lot about the new diagnosis of vitiligo. I have a lot of patients in my practice who were diagnosed with vitiligo years ago and gave up because there wasn’t anything new. They had exhausted all their prior treatment options. I think it’s exciting that we have something new. I’ve been following patients for over 2 decades who, every time they would come in every few years, and say, “Is there anything new? Is there anything new?” This is the first time that I’ve been able to say, “Yes, there is something new.” That’s so exciting, not only for me as a clinician, but also for the patients, because like I said, we haven’t focused, unfortunately, on vitiligo for so many years, and now we have this new treatment option.

Transcript edited for clarity.

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