Background: Janus kinase (JAK) inhibitors, such as abrocitinib, are emerging alternatives to glucocorticoids for treating progressive non-segmental vitiligo (NSV), though long-term data remain limited.
Objective: To assess 52-week efficacy and safety of oral abrocitinib with narrow-band ultraviolet B (NB-UVB) phototherapy in progressive NSV.
Methods: Eleven patients with progressive NSV, resistant to systemic glucocorticoids treatment, received abrocitinib (100 mg/day) for 16 weeks, followed by 100 mg every other day for 36 additional weeks. NB-UVB phototherapy was performed twice weekly. Response was assessed using the Total Vitiligo Area Severity Index (T-VASI) and Facial Vitiligo Area Severity Index (F-VASI). Serum biomarkers and adverse events (AEs) were monitored.
Results: Median improvement increased from 29.2% (IQR 8.8%-38.6%) at week 24 to 39.6% (IQR 27.7%-47.8%) at week 52 (p = 0.043). By week 24, 54.5% achieved T-VASI25, improving to 72.7% by week 52. Non-responders at week 24 showed no further improvement at week 52. Serum CCL20 decreased at weeks 24 and 52 (p = 0.0003), while CXCL10 and IFN-γ remained unchanged. Mild AEs (headache, dizziness, nausea) were reported and no severe AE was observed.
Conclusion: Long-term abrocitinib plus NB-UVB phototherapy demonstrates sustained efficacy and safety in progressive NSV, though non-responders by 24 weeks may not benefit from extension.
Keywords: Janus kinase inhibitor; Refractory vitiligo; abrocitinib; efficacy; narrow-band ultraviolet B; safety.