practicaldermatology.com
Baricitinib combined with narrowband UV-B achieved a modest reduction in disease severity in adults with severe, active nonsegmental vitiligo, but did not meet the prespecified threshold for sufficient repigmentation, new research revealed.
The trial enrolled 49 adult participants with extensive and active nonsegmental vitiligo across four dermatology centers. Patients were randomized 3:1 to receive either baricitinib, 4 mg daily, or placebo for 36 weeks. Narrowband UV-B therapy was added twice weekly from weeks 12 to 36. The primary study endpoint was the mean percentage change in the Vitiligo Area Scoring Index (VASI) score from baseline to week 36.
The baricitinib group demonstrated a mean reduction in total VASI score of 44.8% (95% CI, −58.4% to −31.3%) at week 36, compared to −9.2% (95% CI, −27.7% to 24.7%) in the placebo group. The reduction did not exceed the threshold of 42.9% previously observed with narrowband UV-B alone. Post hoc analysis, however, revealed a significant difference in total VASI score at week 36 between baricitinib plus narrowband UV-B and placebo plus narrowband UV-B (P = 0.02).
Secondary outcomes showed greater improvement in disease activity and quality of life with baricitinib vs. placebo. Adverse events were similar between groups.
"This randomized clinical trial showed that baricitinib, a small molecule inhibiting Janus kinases 1 and 2, combined with phototherapy reduced the activity of the disease and provided rapid and clinically meaningful repigmentation in adults with severe, active vitiligo," the authors concluded.
Source: Seneschal J, et al. JAMA Dermatology. 2025. Doi:10.1001/jamadermatol.2024.5737