Short-term (24 weeks) treatment efficacy and safety of ruxolitinib cream in participants with vitiligo: a systematic review and meta-analysis

Abstract

ImportanceVitiligo is a chronic skin disorder causing depigmentation. There is a lack of evidence-based medical evidence regarding ruxolitinib efficacy and safety for vitiligo.ObjectiveTo assess the efficacy and safety of ruxolitinib cream in the treatment of vitiligo.MethodsThe databases of PubMed, Embase, and Cochrane Library were searched. The literature screening was independently conducted by two reviewers.Data extraction and synthesisFor continuous variables, weighted mean difference (WMD) along with a 95% confidence interval (CI) was performed. For dichotomous outcomes, we calculated the odds ratios (ORs) or risk ratios (RRs), and their corresponding 95% CIs. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Main outcomes and measuresSymptoms, quality of life, and safety were evaluated using various measures, including the Facial Vitiligo Area Scoring Index (F-VASI), Total Vitiligo Area Scoring Index (T-VASI), Facial Body Surface Area (F-BAS), Total Body Surface Area (T-BAS) and Treatment-emergent Adverse Events (TEAEs).ResultsThree trials, involving a total of 830 participants from nine countries were included (female 388, 46.7%, male 442, 53.3%). The meta-analysis demonstrated a significant increase in the likelihood of participants achieving F-VASI75 (OR, 4.34 [95% CI 2.67–7.06]; high), F-VASI50 (OR 4.71 [95% CI 3.24–6.84]; high), T-VASI75 (OR 2.78 [95% CI 1.10–7.00]; moderate), and T-VASI50 (OR 4.47 [95% CI 2.52–7.92]; high) when compared ruxolitinib to vehicle. Ruxolitinib was associated with more lowered percentage change of F-VASI scores (MD − 32.79 [95% CI − 36.37 to − 29.21]; moderate), and T-VASI scores (MD − 20.22 [95% CI − 23.11 to − 17.33]; moderate) from baseline compared to vehicle. There may not be a significant difference in the occurrence of TEAEs between ruxolitinib and vehicle (RR 1.46 [95% CI 0.85–2.49]; high).ConclusionsThe findings suggest that ruxolitinib cream holds promise as a treatment option for vitiligo. Further long-term studies are needed to assess its sustained efficacy and safety profile.Systematic review registrationPROSPERO CRD42023431112.