Efficacy of Janus kinase inhibitor combined with phototherapy in non-segmental vitiligo: systematic review and meta-analysis.
Laiba Shuaib, Kuldeep D Rai, Aneesh K Sangtiani et al.
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In 30 seconds
This systematic review and meta-analysis assessed Janus kinase inhibitors combined with narrowband UVB (NB-UVB) versus NB-UVB alone for adults with non-segmental vitiligo. Four studies involving 217 adults were included. Combination therapy was associated with a greater reduction in total Vitiligo Area Scoring Index (VASI) than NB-UVB alone (mean difference −4.96, 95% CI [−9.29, −0.63], p = 0.02). The analysis also found higher likelihoods of achieving at least 50% and at least 75% repigmentation with combination treatment.
Key findings
- Total VASI was lower with JAK inhibitor plus NB-UVB than with NB-UVB alone (MD = -4.96, 95% CI [-9.29, -0.63], p = 0.02).
- Combination therapy increased the likelihood of achieving ≥50% repigmentation (RR = 6.87, p < 0.00001).
- Combination therapy increased the likelihood of achieving ≥75% repigmentation (RR = 15.13, p = 0.006).
- Sensitivity analyses found reductions in VASI across face/neck, trunk, acral, and extremity regions.
Why it matters
Repigmentation can be difficult to achieve in non-segmental vitiligo, and these pooled findings suggest that adding a JAK inhibitor to NB-UVB may improve outcomes compared with phototherapy alone. The results provide a quantitative basis for further evaluation of combination treatment, while the limited number of included studies means the evidence should be interpreted cautiously.
What to keep in mind
The meta-analysis included only four studies and 217 adults; the abstract does not report follow-up duration or provide further detail on study quality.