52-week long-term follow-up of non-segmental vitiligo treated with oral abrocitinib and narrow-band UVB phototherapy

Summary: Abstract Body: Janus kinase (JAK) inhibitors have begun to be used as investigational therapies in the treatment of progressive non-segmental vitiligo. However, reliable data on the long-term efficacy and safety of oral abrocitinib, a selective JAK1 inhibitor, remains unavailable. We recruited eleven Asian patients with progressive vitiligo who continued to have white patches spreading despite six sessions of intramuscular betamethasone injection. Following the exclusion of contraindications, oral abrocitinib 100 mg once daily was prescribed for 16 weeks. The dosage reduced to 100 mg every other day for an additional 36 weeks. The Vitiligo Area Severity Index (VASI) was used for clinical evaluation. As a result, the mean period from active to stable was 8.0 ± 4.7 weeks. At weeks 24, six patients (54.5%) achieved VASI25, and two patients (18.2%) experienced no improvement. At weeks 52, the number of patients achieving VASI25 increased to eight (72.7%), and only one patient (9.1%) experienced no improvement. At weeks 24, two (28.6%) achieved F-VASI75, two (28.6%) F-VASI50, and one (14.3%) F-VASI25. At weeks 52, two (28.6%) achieved F-VASI90, and three achieved F-VASI50 (42.9%). However, two patients who did not show improvement in F-VASI at weeks 24 still did not repigment at weeks 52. Additionally, when compared to the baseline, serum levels of CCL20 (P = 0.0003) were significantly lower at weeks 24 and 52 although CXCL20 and IFN-γ did not alter significantly. No severe AEs were noted during the 52-week follow-up. In summary, longer-term treatment of non-segmental vitiligo patients with oral abrocitinib in combination with NB-UVB phototherapy demonstrated a favorable benefit-risk profile, with sustained efficacy responses through 52 weeks. Repigmentation on the face, trunk, and even distal extremities may be improved when oral abrocitinib treatment course is prolonged. Nevertheless, patients who developed treatment resistance (with no repigmentation on any part of the body) after 24 weeks would not benefit from an extension of the treatment duration. Zhongyi Xu¹, Yijie Xuan¹, Yuecen Ding¹, Shanglin Jin¹, Leihong Xiang¹, Chengfeng Zhang¹ 1. Huashan Hospital Fudan University, Shanghai, China. Clinical Research: Interventional Research