Abstract
Introduction
A phase 2 trial (NCT04818346) of the oral Janus kinase 1 inhibitor povorcitinib demonstrated substantial total body and facial repigmentation over 52 weeks in adults with extensive nonsegmental vitiligo (NSV). Here, post hoc analyses evaluated povorcitinib efficacy in patients based on demographic and clinical characteristic subgroups, as well as affected body regions.
Methods
Data were pooled for 103 patients in the extension-evaluable population who received povorcitinib (15, 45, or 75 mg once daily) throughout the 52-week study. Efficacy among subgroups was evaluated using achievement of ≥ 50% reduction from baseline in total Vitiligo Area Scoring Index (T-VASI50) and ≥ 50%/≥ 75% reduction from baseline in facial VASI (F-VASI50/F-VASI75). Efficacy in the affected body regions was evaluated using VASI50 responses. Data were analyzed using descriptive statistics, and missing values were imputed as nonresponders.
Results
At Week 52, 34.0% (35/103) of patients achieved T-VASI50, 61.2% (63/103) achieved F-VASI50, and 45.6% (47/103) achieved F-VASI75. Repigmentation occurred across subgroups regardless of patient age, sex, race, Fitzpatrick skin type, affected body surface area, other autoimmune comorbidities, disease duration, or prior NSV treatment. In addition, VASI50 response rates increased consistently and, in most cases, without plateauing for each body region, ranging from 25.8% for the feet to 57.3% for the head and neck (excluding the face). Decreased rates of disease activity were also evident across body regions.
Conclusion
In this exploratory post hoc analysis of adults with extensive NSV, oral povorcitinib produced clinically meaningful repigmentation (as measured by achievement of T-VASI50 and F-VASI75) across patient characteristic subgroups and body regions through 1 year of treatment. Response rates varied by body region, reinforcing the lengthy repigmentation process, especially in nonfacial areas, and highlighting the need to manage patient expectations and encourage adherence to long-term therapy.
Trial Registration
ClinicalTrials.gov identifier, NCT04818346.
Graphical abstract
Supplementary Information
The online version contains supplementary material available at https://doi.org/10.1007/s12325-026-03673-6.
Keywords: F-VASI, INCB054707, JAK inhibitor, JAK1 inhibitor, Oral administration, Povorcitinib, Repigmentation, T-VASI, Vitiligo
Plain Language Summary
Vitiligo is a condition that causes the skin to form white patches. These patches can develop anywhere on the body. In a recent study, people with widespread vitiligo took povorcitinib tablets daily for 1 year. Many saw color return to the white patches of skin on their face and body. The analysis described here examined data from this study and assessed how well the treatment worked in different groups of people based on factors such as age, skin tone, duration of vitiligo, prior treatments, and affected body parts. The analysis included 103 patients who took povorcitinib for 1 year. After a year of treatment, one in three patients had at least half of the lost color return across their body. The face responded even better—nearly half the patients had at least three-quarters of their color return. Importantly, povorcitinib improved skin coloring across different groups of people, regardless of their age, sex (men/women), race, skin tone (fairer/darker), or how much of the body was affected with vitiligo. It also helped people whether they had other autoimmune health problems or not, had vitiligo for a short or long time, or had tried other medicines before. Povorcitinib also worked on different parts of the body, although results were best on the face and the head and neck. Since treatment takes many months and results may appear slowly in some body areas (e.g., the hands and feet), patients should be encouraged to continue treatment long term for the best outcomes.
Supplementary Information
The online version contains supplementary material available at https://doi.org/10.1007/s12325-026-03673-6.
Key Summary Points
| Why carry out this study? |
| In a phase 2 clinical trial, 1 year of treatment with the oral JAK1-selective inhibitor povorcitinib produced substantial repigmentation on the face and total body of patients with extensive nonsegmental vitiligo (NSV) |
| This analysis explored the efficacy of povorcitinib across baseline patient characteristic subgroups and affected body regions in the phase 2 clinical trial |
| What was learned from this study? |
| Repigmentation (measured by ≥ 50% reduction from baseline in total Vitiligo Area Scoring Index [T-VASI50], ≥ 50% reduction from baseline in facial VASI [F-VASI50], and ≥ 75% reduction from baseline in F-VASI [F-VASI75]) was consistent across all patient subgroups, with comparable outcomes regardless of age, sex, race, Fitzpatrick skin type, disease extent, autoimmune comorbidities, duration of NSV, or prior treatment |
| Repigmentation, as measured by VASI50 of individual body regions, occurred steadily and mostly without plateau, with the highest response rates observed in facial areas and slower, yet meaningful, improvement of hands/feet |
| Findings support oral povorcitinib as an effective long-term treatment for extensive NSV while underscoring the need to set patient expectations around gradual nonfacial repigmentation and the importance of sustained therapy |
Digital Features
This article is published with digital features, including a graphical abstract, to facilitate understanding of the article. To view digital features for this article go to https://doi.org/10.6084/m9.figshare.32542554.
Introduction
Vitiligo is a chronic, inflammatory autoimmune disorder characterized by melanocyte loss and skin depigmentation, often leading to substantial psychosocial burden [1]. Effective therapies aim to achieve repigmentation [2, 3], but treatment efficacy may vary based on demographics and clinical characteristics such as age, skin type, and disease duration [1, 4]. In addition, repigmentation can vary across body regions, with facial and proximal regions generally responding more favorably to treatment than more resistant sites like the hands and feet [4–6].
Povorcitinib is an oral, small-molecule, selective Janus kinase 1 inhibitor that demonstrated substantial repigmentation in patients with extensive nonsegmental vitiligo (NSV) through 52 weeks of treatment in a phase 2 dose-ranging study (NCT04818346) [7]. Povorcitinib was generally well tolerated, with no serious adverse events related to treatment through Week 52 [7]. All doses of povorcitinib produced a statistically superior percentage change from baseline in the total Vitiligo Area Scoring Index (T-VASI [all body regions, including the face]; primary endpoint) compared with placebo. Additionally, numerically higher percentages of patients treated with povorcitinib achieved ≥ 50% reduction from baseline in T-VASI (T-VASI50; key secondary endpoint) and ≥ 50%/≥ 75% reduction from baseline in facial VASI (F-VASI50/F-VASI75; exploratory endpoints) versus placebo. Attainment of F-VASI75 and T-VASI50 is considered an indicator of treatment success by both patients and clinicians [2]. Here, post hoc analyses were conducted to assess the efficacy of povorcitinib treatment across patient characteristic subgroups and body regions.
Methods
Study Design and Patients
The phase 2 study methodology has been published previously [7]. In brief, the study included 171 adults (18–75 years old) with a clinical diagnosis of NSV, depigmented areas affecting ≥ 0.5% of facial body surface area (F-BSA) and ≥ 8% of total BSA (T-BSA), and scores ≥ 0.5 on F-VASI and ≥ 8 on T-VASI. Patients were randomized 1:1:1:1 to receive one of three doses of povorcitinib (15, 45, or 75 mg) or placebo once daily for 24 weeks of double-blinded treatment. Thereafter, during the extension period, patients initially randomized to placebo or povorcitinib 15 mg were allocated to povorcitinib 75 mg, and patients initially randomized to povorcitinib 45 mg or 75 mg maintained their assigned dose through completion at Week 52. These post hoc analysis pooled data for the 103 patients originally randomized to povorcitinib (i.e., patients who received povorcitinib 15, 45, or 75 mg from Day 1) who continued into the extension period (i.e., extension-evaluable population; Figure S1).
The trial was carried out in accordance with the Declaration of Helsinki, study protocol, applicable Good Clinical Practice, and local regulatory requirements. An institutional review board or independent ethics committee approved the study protocol and amendments at each site. All patients provided written informed consent before participating in the trial, including for publication of clinical photos.
Assessments
Percentages of patients achieving T-VASI50, F-VASI50, and F-VASI75 at Week 52 were assessed using baseline patient demographics and clinical characteristics. Analyzed subgroups were age group (≤ 40 years, > 40 years), sex (male, female), race (white, non-white), Fitzpatrick skin type (I–III, IV–VI), F-BSA (≤ 1.5%, > 1.5%), T-BSA (≤ 20%, > 20%), other autoimmune disorders (no, yes), disease duration (< 10 years, ≥ 10 years), and previous NSV therapy (no, yes; topical corticosteroids, topical calcineurin inhibitors, phototherapy). In addition, percentages of patients achieving VASI50 through Week 52 were assessed by affected body region (face [including nose and eyelids, but excluding lips, scalp, ears, and neck], head and neck [excluding face], trunk [including genitalia], upper extremities [including axillae], hands, lower extremities [including buttocks], and feet), and all body regions combined (separately analyzed including and excluding the face, because it is considered most responsive to repigmentation). Clinical signs of disease activity (confetti-like depigmentation, Koebner phenomenon, and/or hypochromic areas or borders) and therapeutic prognosis (leukotrichia) were also evaluated by body region at baseline and Week 52.
Statistical Analysis
For subgroup and body region analyses, missing values were imputed as nonresponders. Data were summarized using descriptive statistics, and 95% confidence intervals (CIs) were calculated using the Clopper-Pearson exact method. Only patients with baseline VASI > 0 for each body region were included in the respective body region analyses.
Results
Baseline Demographics and Disease Characteristics
Among the 103 patients included in these post hoc analyses, 61 (59.2%) were female, 70 (68.0%) had fairer skin (Fitzpatrick skin types I–III), and 33 (32.0%) had darker skin (types IV–VI; Table 1). Baseline mean (SD) disease duration was 19.2 (14.3) years, and T-VASI and F-VASI were 24.9 (19.1) and 1.3 (0.8), respectively.
Table 1.
Patient demographics and baseline clinical characteristics (extension-evaluable population)
| Characteristic | Povorcitinib | Total (N = 103) |
||
|---|---|---|---|---|
| 15 mg → 75 mg (n = 37) |
45 mg → 45 mg (n = 32) |
75 mg → 75 mg (n = 34) |
||
| Age, median (range), years | 45.0 (23–67) | 52.5 (26–72) | 52.5 (24–73) | 51.0 (23–73) |
| Sex, n (%) | ||||
| Male | 10 (27.0) | 15 (46.9) | 17 (50.0) | 42 (40.8) |
| Female | 27 (73.0) | 17 (53.1) | 17 (50.0) | 61 (59.2) |
| Race, n (%) | ||||
| White | 28 (75.7) | 28 (87.5) | 23 (67.6) | 79 (76.7) |
| Black/African American | 3 (8.1) | 1 (3.1) | 2 (5.9) | 6 (5.8) |
| Asian | 3 (8.1) | 0 | 5 (14.7) | 8 (7.8) |
| Other* | 3 (8.1) | 3 (9.4) | 4 (11.8) | 10 (9.7) |
| Fitzpatrick skin type, n (%) | ||||
| I–III | 24 (64.9) | 26 (81.3) | 20 (58.8) | 70 (68.0) |
| IV–VI | 13 (35.1) | 6 (18.8) | 14 (41.2) | 33 (32.0) |
| F-VASI, mean (SD) | 1.3 (0.8) | 1.4 (0.8) | 1.0 (0.6) | 1.3 (0.8) |
| T-VASI, mean (SD) | 26.9 (20.2) | 23.7 (22.0) | 23.9 (14.8) | 24.9 (19.1) |
| F-BSA, mean (SD), % | 1.4 (0.8) | 1.5 (0.8) | 1.1 (0.7) | 1.4 (0.8) |
| ≤ 1.5%, n (%) | 24 (64.9) | 18 (56.3) | 27 (79.4) | 69 (67.0) |
| > 1.5%, n (%) | 13 (35.1) | 14 (43.8) | 7 (20.6) | 34 (33.0) |
| T-BSA, mean (SD), % | 30.7 (21.0) | 25.1 (22.1) | 27.3 (16.3) | 27.8 (19.9) |
| ≤ 20%, n (%) | 16 (43.2) | 18 (56.3) | 14 (41.2) | 48 (46.6) |
| > 20%, n (%) | 21 (56.8) | 14 (43.8) | 20 (58.8) | 55 (53.4) |
| Other autoimmune disorders, n (%) | 10 (27.0) | 7 (21.9) | 12 (35.3) | 29 (28.2) |
| Disease duration, mean (SD), years | 16.3 (13.0) | 20.6 (16.2) | 21.1 (13.5) | 19.2 (14.3) |
| Disease activity,† n (%) | ||||
| ≥ 1 active lesion in ≥ 1 anatomic area | 21 (56.8) | 15 (46.9) | 13 (38.2) | 49 (47.6) |
| No active lesions | 16 (43.2) | 17 (53.1) | 21 (61.8) | 54 (52.4) |
| Previous therapy,‡ n (%) | 34 (91.9) | 25 (78.1) | 34 (100) | 93 (90.3) |
| TCS | 21 (56.8) | 13 (40.6) | 19 (55.9) | 53 (51.5) |
| TCI | 11 (29.7) | 15 (46.9) | 15 (44.1) | 41 (39.8) |
| Phototherapy | 14 (37.8) | 10 (31.3) | 25 (73.5) | 49 (47.6) |
F-BSA facial body surface area; F-VASI facial Vitiligo Area Scoring Index; T-BSA total body surface area; TCI topical calcineurin inhibitor; TCS topical corticosteroid; T-VASI total Vitiligo Area Scoring Index
Baseline was study Day 1
*African, Central/South American, Mixed, or did not specify
† Each VASI anatomic region was assessed for signs of disease activity, including the presence of confetti-like depigmentation (yes/no), Koebner phenomenon (yes/no), and/or hypochromic areas/borders (trichrome lesions; yes/no)
‡ Patients could have used multiple previous lines of therapy
Efficacy of Povorcitinib by Subgroup
At Week 52, 34.0% (35/103) of patients who received any dose of povorcitinib from Day 1 achieved T-VASI50, 61.2% (63/103) achieved F-VASI50, and 45.6% (47/103) achieved F-VASI75 (Figs. 1, 2, 3). T-VASI50, F-VASI50, and F-VASI75 responses were observed across all demographic and clinical characteristic subgroups. Notably, response rates appeared similar between patients with Fitzpatrick skin types I–III and IV–VI (fairer vs darker skin), those with or without other autoimmune diseases, those with lesser or greater affected T-BSA (≤ 20% vs > 20%), or those with shorter or longer disease duration (< 10 vs ≥ 10 years). Numerically higher response rates (≥ 15% difference) were observed in select subgroups; however, these were inconsistent across T-VASI50, F-VASI50, and F-VASI75 endpoints. T-VASI50 response rates were numerically higher among female (41.0% [25/61]) versus male patients (23.8% [10/42]; Fig. 1). Trends toward higher F-VASI50 response rates were observed among patients with baseline F-BSA ≤ 1.5% (66.7% [46/69]) compared with F-BSA > 1.5% (50.0% [17/34]; Fig. 2). F-VASI75 response rates were numerically higher among patients who had received any prior NSV treatment (47.3% [44/93] vs 30.0% [3/10] of patients without prior NSV treatment; Fig. 3). These results should be interpreted with caution, given the small number of patients in some of the subgroups.
Fig. 1.
T-VASI50 response at Week 52 by demographics and baseline clinical characteristics among patients who received povorcitinib (extension-evaluable population). F-BSA facial body surface area; T-BSA total body surface area; TCI topical calcineurin inhibitor; TCS topical corticosteroid; T-VASI50 ≥ 50% reduction from baseline in total Vitiligo Area Scoring Index
Fig. 2.
F-VASI50 response at Week 52 by demographics and baseline clinical characteristics among patients who received povorcitinib (extension-evaluable population). F-BSA facial body surface area; F-VASI50 ≥ 50% reduction from baseline in facial Vitiligo Area Scoring Index; T-BSA total body surface area; TCI topical calcineurin inhibitor; TCS topical corticosteroid
Fig. 3.
F-VASI75 response at Week 52 by demographics and baseline clinical characteristics among patients who received povorcitinib (extension-evaluable population). F-BSA facial body surface area; F-VASI75 ≥ 75% reduction from baseline in facial Vitiligo Area Scoring Index; T-BSA total body surface area; TCI topical calcineurin inhibitor; TCS topical corticosteroid
Efficacy of Povorcitinib by Body Region
Among patients treated with povorcitinib from Day 1, VASI50 response rates increased steadily through 52 weeks across all body regions and mostly without plateau (Fig. 4). VASI50 score for all body regions (including face) was achieved by 7.8% (8/103) of patients at Week 24 and increased to 36.9% (38/103) at Week 52; VASI50 for all body regions (excluding face) was achieved by 8.7% (9/103) and 34.0% (35/103) of patients, respectively. The highest response rates were observed in the face and the head-and-neck regions, where more than half of patients achieved VASI50 responses at Week 52 (61.2% [63/103] and 57.3% [59/103], respectively). This was followed by improvements in the upper (40.8% [42/103]) and lower extremities (38.2% [39/102]) and the trunk (34.3% [35/102]). Response rates in traditionally challenging areas were also notable, with 37.0% (37/100) of patients achieving VASI50 on the hands and 25.8% (25/97) on the feet. Additionally, decreased rates of disease activity indicators and leukotrichia were evident across body regions at Week 52 versus baseline (Table 2). Representative clinical images are shown in Fig. 5.
Fig. 4.
VASI50 response through 52 weeks by body region among patients who received povorcitinib (extension-evaluable population). a All body regions (including and excluding face) and face,† b head and neck‡ and trunk,§ c upper¶ and lower# extremities, and d hands and feet. Missing values were imputed as nonresponders. Only patients with baseline VASI > 0 for each body region were included in the respective body region analyses. VASI50, ≥ 50% reduction from baseline in Vitiligo Area Scoring Index. †Face includes nose and eyelids, but excludes lips, scalp, ears, and neck; ‡head and neck excludes the face; §trunk includes genitalia; ¶upper extremities include axillae; #lower extremities include buttocks
Table 2.
Changes in signs of disease activity and prognosis† by body region from baseline to week 52 (N = 103)
| Body region, n (%) | Leukotrichia | Confetti-like depigmentation | Koebner phenomenon | Hypochromic areas/borders | ||||
|---|---|---|---|---|---|---|---|---|
| Baseline | Week 52 | Baseline | Week 52 | Baseline | Week 52 | Baseline | Week 52 | |
| Total body | ||||||||
| Including face | 16 (15.5) | 5 (4.9) | 44 (42.7) | 20 (19.4) | 16 (15.5) | 2 (1.9) | 24 (23.3) | 10 (9.7) |
| Excluding face | 10 (9.7) | 3 (2.9) | 43 (41.7) | 20 (19.4) | 15 (14.6) | 1 (1.0) | 21 (20.4) | 9 (8.7) |
| Face | 12 (11.7) | 3 (2.9) | 11 (10.7) | 12 (11.7) | 8 (7.8) | 1 (1.0) | 16 (15.5) | 9 (8.7) |
| Head and neck | 7 (6.8) | 3 (2.9) | 13 (12.6) | 10 (9.7) | 9 (8.7) | 0 | 8 (7.8) | 6 (5.8) |
| Trunk | 5 (4.9) | 0 | 20 (19.4) | 11 (10.7) | 9 (8.7) | 1 (1.0) | 12 (11.7) | 6 (5.8) |
| Upper extremities | 3 (2.9) | 0 | 30 (29.1) | 17 (16.5) | 12 (11.7) | 1 (1.0) | 15 (14.6) | 9 (8.7) |
| Lower extremities | 3 (2.9) | 0 | 27 (26.2) | 14 (13.6) | 9 (8.7) | 1 (1.0) | 14 (13.6) | 8 (7.8) |
| Hands | 2 (1.9) | 0 | 21 (20.4) | 16 (15.5) | 10 (9.7) | 0 | 9 (8.7) | 6 (5.8) |
| Feet | 3 (2.9) | 0 | 15 (14.6) | 10 (9.7) | 8 (7.8) | 1 (1.0) | 8 (7.8) | 5 (4.9) |
†Each Vitiligo Area Scoring Index anatomic region was assessed for signs of disease activity, including the presence of confetti-like depigmentation (yes/no), Koebner phenomenon (yes/no), and/or hypochromic areas/borders (trichrome lesions; yes/no), as well as the presence of leukotrichia (yes/no), an indicator of poor prognosis. Patients could have ≥ 1 sign of activity and/or leukotrichia in any body region
Fig. 5.
Clinical images showing repigmentation of body regions with povorcitinib. Images of patient 1 are reproduced from Pandya AG, et al. J Am Acad Dermatol. 2025;93(4):946–955. Supplementary Appendix. https://doi.org/10.17632/52jtsjjd24.1. Use is permitted under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/legalcode); patient images are unaltered, but disease extent data were updated as relevant to the presented analyses. T-VASI total Vitiligo Area Scoring Index; VASI Vitiligo Area Scoring Index
Discussion
Following 52 weeks of treatment with oral povorcitinib, many patients with extensive NSV achieved clinically meaningful repigmentation as measured by T-VASI50 (34.0%) and F-VASI75 (45.6%) responses [2, 8]. In this exploratory post hoc analysis, patients achieved meaningful improvements across subgroups defined by demographic and clinical characteristics, including those with longstanding and extensive disease and those with prior treatment history. There was some variability in treatment responses among certain patient subgroups, likely influenced by small sample sizes, underscoring the need for further investigation in larger, more balanced cohorts.
This analysis also showed improvements in repigmentation across affected body regions through 1 year of povorcitinib treatment, as indicated by VASI50 responses. The extent of repigmentation varied by anatomic location, with the highest response rates observed for the face and head-and-neck, areas known to be more responsive to therapy [4–6, 9]. Encouragingly, even in the repigmentation-resistant hands and feet [4, 5], VASI50 responses were achieved in 37.0% and 25.8% of patients, respectively. Notably, however, VASI scoring does not provide granularity regarding repigmentation in specific areas of the hands and feet that are known to be highly treatment resistant, such as the inner wrists and tips of the fingers and toes.
Vitiligo is a chronic condition, and the repigmentation process usually takes several months to years and varies depending on the location of the depigmentation [10]. This process begins with suppression of the immune response (i.e., halting melanocyte loss), followed by activation of melanocyte precursors, mainly located in the hair follicle bulge and infundibulum, which proliferate, migrate to the epidermis, and differentiate into melanocytes to repopulate and repigment the skin [11, 12]. Repigmentation is often more limited or delayed in nonfacial body regions with low hair follicle density, or regions with leukotrichia, indicating depletion of follicular melanocyte precursors [11, 12]. These observations underscore the importance of managing patient expectations and encouraging adherence to long-term therapy to achieve successful outcomes [13, 14]. Notably, the absence of a repigmentation plateau at Week 52 in this study suggests that further improvement may be achievable with continued therapy beyond 1 year. Although repigmentation may be accelerated with the addition of phototherapy in some patients [15, 16], a commitment to consistent, long-term treatment remains critical.
Limitations of these analyses include the exploratory post hoc design, small sample sizes in some subgroups despite pooling of povorcitinib treatment groups, use of descriptive analyses, and lack of a comparator arm, which limit meaningful interpretation and generalizability. Including only patients who were randomized to and continued povorcitinib in the extension-evaluable population may have introduced selection bias. Moreover, these analyses were based on clinical trial data, which may not be generalizable to real-world clinical settings. The trends identified here require confirmation in studies evaluating larger real-world patient populations. Finally, because the analysis includes outcomes up to Week 52, longer-term follow-up is needed to better understand the upper limits and durability of repigmentation with prolonged povorcitinib treatment.
Conclusion
Findings from this exploratory post hoc analysis highlight the potential efficacy of oral povorcitinib across a range of subgroups, with many patients of varying demographics and clinical characteristics achieving repigmentation indicative of treatment success (i.e., T-VASI50 and F-VASI75) [2, 8]. Importantly, repigmentation per VASI50 response was observed across all body regions. Although repigmentation rates varied by body region (e.g., slower for nonfacial and distal body regions), continued improvement was observed without plateau in most body areas and may increase further with longer duration treatment. These findings may be helpful in managing realistic expectations among patients and their caregivers, ultimately promoting adherence to long-term treatment.
Supplementary Information
Below is the link to the electronic supplementary material.
Acknowledgements
The authors thank the patients, investigators, and investigational sites whose participation made this study possible. They also thank Kurt Brown, MD, Global Program Head for Povorcitinib at Incyte Corporation (Wilmington, DE, USA), for his contributions to the study.
Medical Writing, Editorial, and Other Assistance
Writing assistance was provided by Mitali Choudhury, PhD, an employee of ICON (Blue Bell, PA, USA), and was funded by Incyte.
Author Contributions
Lois Erskine, Leandro L. Santos, and Zhenyi Xue designed these post hoc analyses; all authors (Thierry Passeron, Amit G. Pandya, Khaled Ezzedine, Nanja van Geel, Lois Erskine, Leandro L. Santos, Zhenyi Xue, and Andrew Blauvelt) analyzed and interpreted the data, provided critical revision of the manuscript, and approved the content for publication.
Funding
This study, and the mandatory Rapid Service Fee and Open Access Fee for the publication, were funded by Incyte Corporation (Wilmington, DE, USA).
Data Availability
Incyte Corporation (Wilmington, DE, USA) is committed to data sharing that advances science and medicine while protecting patient privacy. Qualified external scientific researchers may request anonymized datasets owned by Incyte for the purpose of conducting legitimate scientific research. Researchers may request anonymized datasets from any interventional study (except Phase 1 studies) for which the product and indication have been approved on or after 1 January 2020 in at least one major market (e.g., US, EU, JPN). Data will be available for request after the primary publication or 2 years after the study has ended. Information on Incyte’s clinical trial data sharing policy and instructions for submitting clinical trial data requests are available at: https://www.incyte.com/Portals/0/Assets/Compliance%20and%20Transparency/clinical-trial-data-sharing.pdf?ver=2020-05-21-132838-960.
Declarations
Conflict of Interest
Thierry Passeron has received grants and/or honoraria from AbbVie, ACM Pharma, Almirall, Amgen, Astellas, Bristol Myers Squibb, Calypso, Celgene, Clinuvel, Galderma, Genzyme/Sanofi, GlaxoSmithKline, Incyte, Janssen, LEO Pharma, Eli Lilly, Novartis, Pfizer, Sun Pharmaceuticals, Takeda, UCB, and Vyne Therapeutics; is the cofounder of NIKAIA Pharmaceuticals; and has patents on WNT agonists or GSK3b antagonist for repigmentation of vitiligo and on the use of CXCR3B blockers in vitiligo. Amit G. Pandya has served as an investigator for Avita, Clinuvel, and Incyte; a consultant for AbbVie, Avita, Boehringer Ingelheim, Incyte, Lilly, Pfizer, Sun Pharma, Thalocan, Villaris, Vimela, Vyne, and WCG; and has partial ownership of Tara Medical. Khaled Ezzedine is a consultant for AbbVie, Almirall, Bristol Myers Squibb, Incyte Corporation, La Roche-Posay, Lilly, Pfizer, Pierre Fabre, and Sanofi. Nanja van Geel received grants and/or is a consultant and/or investigator for AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Idorsia Pharmaceuticals, Incyte, Merck/MSD, Novartis, Pfizer, and Takeda; and is chair of the Vitiligo Task Force for the European Academy of Dermatology and Venereology (EADV). Lois Erskine, Leandro L. Santos, and Zhenyi Xue are employees and shareholders of Incyte. Andrew Blauvelt has served as a speaker (received honoraria) for Almirall, Eli Lilly, LEO Pharma, Sanofi, and UCB; has served as a scientific advisor (received honoraria) for AbbVie, Almirall, Alumis, Amgen, AnaptysBio, Apogee, Arcutis, Eli Lilly, Incyte, Janssen, Khanda Therapeutics, LEO Pharma, Novartis, Oruka, Pfizer, Re-AIM, Regeneron, Sanofi, Sun Pharma, Takeda, and UCB; and owns stock in Lipidio and Oruka.
Ethical Approval
The trial was carried out in accordance with the Declaration of Helsinki, study protocol, applicable Good Clinical Practice, and local regulatory requirements. An institutional review board or independent ethics committee approved the study protocol and amendments at each site. All patients provided written informed consent before participating in the trial, including for publication of clinical photos.
Footnotes
Prior Presentations: Data from this study were presented at the American Academy of Dermatology (AAD) Annual Meeting (March 8–12, 2024; San Diego, CA, USA; Poster #53,962), with encores at the Revolutionizing Atopic Dermatitis, Alopecia Areata, and Vitiligo (RAVE) Conference (June 8–10, 2024; Chicago, IL, USA; Poster #722), and at the European Academy of Dermatology and Venereology (EADV) Congress (September 25–28, 2024; Amsterdam, Netherlands; Poster #3016).
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References
- 1.Bergqvist C, Ezzedine K. Vitiligo: a review. Dermatology. 2020;236(6):571–92. [DOI] [PubMed] [Google Scholar]
- 2.Kitchen H, Wyrwich KW, Carmichael C, et al. Meaningful changes in what matters to individuals with vitiligo: content validity and meaningful change thresholds of the Vitiligo Area Scoring Index (VASI). Dermatol Ther (Heidelb). 2022;12(7):1623–37. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Eleftheriadou V, Atkar R, Batchelor J, et al. British Association of Dermatologists guidelines for the management of people with vitiligo 2021. Br J Dermatol. 2022;186(1):18–29. [DOI] [PubMed] [Google Scholar]
- 4.Hallaji Z, Ghiasi M, Eisazadeh A, Damavandi MR. Evaluation of the effect of disease duration in generalized vitiligo on its clinical response to narrowband ultraviolet B phototherapy. Photodermatol Photoimmunol Photomed. 2012;28(3):115–9. [DOI] [PubMed] [Google Scholar]
- 5.Esmat SM, El-Tawdy AM, Hafez GA, et al. Acral lesions of vitiligo: why are they resistant to photochemotherapy? J Eur Acad Dermatol Venereol. 2012;26(9):1097–104. [DOI] [PubMed] [Google Scholar]
- 6.Passeron T, Harris JE, Pandya AG, et al. Repigmentation by body region in patients with vitiligo treated with ruxolitinib cream over 52 weeks. J Eur Acad Dermatol Venereol. 2025;39(3):e251–4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Pandya AG, Ezzedine K, Passeron T, et al. Efficacy and safety of the oral Janus kinase 1 inhibitor povorcitinib in patients with extensive vitiligo in a phase 2, randomized, double-blinded, dose-ranging, placebo-controlled study. J Am Acad Dermatol. 2025;93(4):946–55. [DOI] [PubMed] [Google Scholar]
- 8.Narayan VS, Uitentuis SE, Bekkenk MW, Wolkerstorfer A. What is successful repigmentation in vitiligo from the point of view of patients? Br J Dermatol. 2021;184(1):165–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Hamzavi I, Rosmarin D, Harris JE, et al. Efficacy of ruxolitinib cream in vitiligo by patient characteristics and affected body areas: descriptive subgroup analyses from a phase 2, randomized, double-blind trial. J Am Acad Dermatol. 2022;86(6):1398–401. [DOI] [PubMed] [Google Scholar]
- 10.Rosmarin D, Passeron T, Pandya AG, et al. Two phase 3, randomized, controlled trials of ruxolitinib cream for vitiligo. N Engl J Med. 2022;387(16):1445–55. [DOI] [PubMed] [Google Scholar]
- 11.McElroy J, Casquejo RJ, Yu H, et al. Understanding the mechanism of disease of vitiligo and the impact on clinical management. J Dermatol Physician Assist. 2025;19(1):28–35. [Google Scholar]
- 12.Birlea SA, Goldstein NB, Norris DA. Repigmentation through melanocyte regeneration in vitiligo. Dermatol Clin. 2017;35(2):205–18. [DOI] [PubMed] [Google Scholar]
- 13.Valle Y, Lotti T, Towheed S, Sigova J. Mapping the vitiligo patient journey: from awareness to treatment or coping strategies. Front Rehabil Sci. 2025;5:1511053. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Feng H, Xu X, Qi S, et al. Knowledge, attitude, and practice toward vitiligo among vitiligo patients: a mediation analysis. Sci Rep. 2025;15(1):4741. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Luo L, Huang J, Fu C, et al. The efficacy of combined phototherapy with topical therapy in vitiligo: a network meta-analysis. J Dermatolog Treat. 2025;36(1):2483808. [DOI] [PubMed] [Google Scholar]
- 16.Pandya AG, Harris JE, Lebwohl M, et al. Addition of narrow-band UVB phototherapy to ruxolitinib cream in patients with vitiligo. J Invest Dermatol. 2022;142(12):3352-3355.e4. [DOI] [PubMed] [Google Scholar]
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