Vol. 7, Issue 1, Part A (2025)

Background: Vitiligo a chronic autoimmune dermatological condition characterized by the progressive loss of epidermal melanocytes leading to depigmented macules on the skin. Non-segmental vitiligo (NSV) is the most prevalent form, accounting for approximately 90% of all cases. It typically presents with bilateral symmetrical patches that may coalesce over time. The psychosocial impact of vitiligo is significant, often affecting patients' quality of life due to cosmetic concerns and societal stigma. Current therapeutic options include topical corticosteroids calcineurin inhibitors narrowband ultraviolet B (NB-UVB) phototherapy, and systemic immunomodulators. However, these treatments are often associated with limited efficacy or side effects necessitating the development of novel therapeutic strategies.
Objective: This study aimed to evaluate the clinical efficacy and safety of ruxolitinib 1.5% cream a topical Janus kinase (JAK) inhibitor in adult patients diagnosed with non-segmental vitiligo. The intervention was conducted at a private dermatology clinic located in Wasit Province, Iraq, over a 12-month period from January 2024 to January 2025.
Methods: A prospective open-label, interventional clinical trial was carried out involving thirty adult participants with stable NSV. All patients applied ruxolitinib 1.5% cream twice daily to depigmented areas without concomitant therapies. Clinical outcomes were assessed using standardized tools including the Vitiligo Area Scoring Index (VASI), Vitiligo European Task Force (VETF) score and the Vitiligo Impact Scale (VIS) at baseline 3 months, 6 months and 12month post-treatment initiation. Safety was evaluated through monitoring of adverse events throughout the study period.
Results: After 12 months of treatment, 83.3% of patients achieved ≥50% improvement in VASI scores with the mean VASI decreasing from 4.8±1.2 at baseline to 2.1±0.9 (p<0.001). Significant improvements were also noted in VETF and VIS scores indicating both clinical repigmentation and enhanced quality of life. No serious adverse events were reported, and only mild transient application site reactions were observed.
Conclusion: Ruxolitinib 1.5% cream demonstrat promising therapeutic potential in managing non-segmental vitiligo offering a safe and effective alternative for long term management These findings support its use in real-world clinical settings particularly in resource-limited settings like Iraq.