Localized Janus Kinase Inhibition Modulation as Standalone or Synergistic Therapy With Narrowband UVB Photo Stimulation in Vitiligo Management: A Systematic Review and Meta-Analysis

Abstract

Background

Vitiligo is a chronic autoimmune dermatosis characterized by progressive hypopigmentation, which affects ~0.2%–2% of the global population. This condition can have significant psychosocial impacts, particularly in individuals with darker skin phenotypes. Recent studies have suggested that Janus kinase (JAK) inhibitors, especially topical ruxolitinib, could offer therapeutic potential in managing vitiligo.

Objective

To systematically review the therapeutic efficacy, safety profile, and potential synergistic effects of topical JAK inhibitors, particularly ruxolitinib, in the treatment of vitiligo.

Methods

A systematic review was conducted in accordance with the PRISMA guidelines. Data from 6 studies, encompassing 385 subjects, were synthesized. The primary outcome measure was the improvement in Vitiligo Area Scoring Index (VASI), and the methodological quality was assessed using the MINORS scale.

Results

Topical ruxolitinib demonstrated a statistically significant improvement in VASI scores (pooled estimate = 0.58; 95% CI: 0.44–0.73; p ≤ 0.001). The synergistic effect of ruxolitinib combined with narrowband ultraviolet B (NB-UVB) phototherapy yielded a mean VASI score improvement of 37.6%. Furthermore, 30.4% of patients receiving 1.5% ruxolitinib cream achieved a 75% improvement in facial VASI (F-VASI) scores.

Conclusion

Topical JAK inhibitors, including ruxolitinib, show considerable efficacy in improving VASI scores and facilitating repigmentation in vitiligo patients. The combination of JAK inhibitors with NB-UVB therapy demonstrates enhanced therapeutic effects. These findings underscore the potential of JAK inhibitors as effective treatment modalities, although further research is needed to standardize treatment protocols and evaluate long-term impacts on patient quality of life.