- Design
- Multicentre retrospective cohort, 34 Italian centres
- Population
- 860 patients aged 12+ with non-segmental vitiligo; 229 followed to 52 weeks
- Primary outcome
- F-VASI75 and F-VASI90 at 24 and 52 weeks
- Effect
- F-VASI75 18.5% at 24 weeks, 38.4% at 52 weeks; F-VASI90 5.7% to 25.8%
A retrospective cohort across 34 Italian centres followed 860 people aged 12 or older with non-segmental vitiligo using ruxolitinib 1.5% cream twice daily. Most had long-standing disease (mean 13.5 years) and 84% had been treated before.
Facial repigmentation of 75% (F-VASI75) was reached by 18.5% at 24 weeks and 38.4% of the 229 who reached 52 weeks; F-VASI90 rose from 5.7% to 25.8%. Starting treatment in summer (adjusted OR 6.7, 95% CI 2.7-16.8) and Koebner phenomenon (aOR 1.6) predicted early response. Moderate to severe anxiety fell from 37% at baseline to 11% at 24 weeks. Adverse events were mild in 98.9% and 1.5% stopped.
Patients often stop topical treatment when little has changed at three months. These data show that response builds slowly and that a year is a fairer judge, in a population closer to clinic than the registration trials.
The 52-week figures come from about a quarter of the cohort, so they may overstate the eventual response rate.
- Set expectations: meaningful facial repigmentation often takes 6 to 12 months.
- Consider starting in spring or summer, when natural light may help.
- Screen for anxiety and low mood at baseline; the burden is high.
- Use photographs at baseline and each review to show progress.
Why it matters
Judging a topical vitiligo treatment at three months risks abandoning it just before it starts to work.
Don't overread it
This was retrospective without a control group, and only 229 patients had reached 52 weeks, so later response rates are uncertain.
The statistics, in plain English
The summer-start odds ratio of 6.7 has a wide confidence interval (2.7 to 16.8), so the direction is convincing but the size is not. Improvements in anxiety without a comparison group could partly reflect time and attention rather than repigmentation.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for dermatology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free