Predictors and clinical impact of super-response in vitiligo patients treated with topical ruxolitinib

BACKGROUNDResponse to topical ruxolitinib in nonsegmental vitiligo is heterogeneous, and early predictors of repigmentation may help personalize treatment.

OBJECTIVETo identify baseline predictors of super-response to topical ruxolitinib 1.5% cream and evaluate the association between early and subsequent clinical outcomes.

METHODSWe conducted a retrospective, single-center cohort study of patients with nonsegmental vitiligo treated with topical ruxolitinib 1.5% cream as monotherapy or in combination with concomitant therapies. Assessments were performed at baseline, 3 months (T1), and 6 months (T2). Super-responders were defined as patients achieving both F-VASI75 and T-VASI50 at T1. Baseline predictors were evaluated using multivariable logistic regression.

RESULTSApproximately 25% of patients were super-responders, with similar rates across treatment groups. Super-responders had lower baseline disease activity and severity, shorter disease duration, and less frequent acral/distal involvement. Baseline Vitiligo Signs of Activity Score (VSAS) was the only independent predictor of super-response. Overall, patients showed progressive improvement in repigmentation and disease activity, with greater responses in facial lesions.

CONCLUSIONSTopical ruxolitinib produced progressive clinical improvement. Lower baseline disease activity, measured by VSAS, identified patients more likely to achieve an early super-response and may help guide personalized treatment strategies.

Abstract from PubMed