The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Predictors of Response to Topical Ruxolitinib in Non‐segmental Vitiligo: A Narrative Review
Abstract
Topical ruxolitinib 1.5% cream is the first approved therapy for repigmentation in non‐segmental vitiligo. However, treatment response varies, and reliable predictors of efficacy remain undefined. This narrative review examined clinical trials and observational studies investigating factors associated with response to ruxolitinib cream. A comprehensive search of MEDLINE, Cochrane CENTRAL and ClinicalTrials.gov (through June 2025) identified 14 eligible studies. Anatomical site was the most consistent predictor, with facial lesions showing the highest repigmentation rates and acral areas demonstrating poor response. Early clinical improvement was associated with better long‐term outcomes. Long‐term data indicated that repigmentation can persist after treatment discontinuation in a substantial proportion of patients. Demographic and disease‐related variables, including age, sex, disease duration and phototype, showed mixed results across studies. Adjunctive narrowband UVB improved repigmentation in initial non‐responders but provided limited benefit in early responders. Exploratory biomarker data suggested that Th2 cytokine profiles and reductions in CXCL10 levels may be linked to response, although these findings remain unvalidated. Overall, anatomical location and early clinical response appear to be the most reliable indicators of ruxolitinib efficacy. Further studies with standardized endpoints and predictive modelling are needed to guide individualized treatment strategies in vitiligo.
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JAK inhibitors, most notably topical ruxolitinib for nonsegmental vitiligo, are used clinically, while systemic JAK inhibitors remain under investigation or off-label in many settings.
“Advances in understanding the interferon-γ/JAK-STAT axis have led to clinical use of JAK inhibitors in vitiligo, most notably with topical ruxolitinib for nonsegmental vitiligo, while systemic JAK inhibitors remain under investigation or off-label in many settings.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [54]
Narrowband UVB phototherapy is a cornerstone modality in vitiligo that promotes melanocyte proliferation, migration from hair follicles, and immunomodulation by suppressing pathogenic T-cell responses.
“Narrowband UVB phototherapy is a cornerstone modality that promotes melanocyte proliferation, migration from hair follicles, and immunomodulation by suppressing pathogenic T-cell responses.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [54]
Combination therapies, particularly JAK inhibitors with phototherapy, appear to enhance efficacy and durability of response in vitiligo.
“Combination therapies, particularly JAK inhibitors with phototherapy, appear to enhance efficacy and durability of response.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [54]
Modern vitiligo management is shifting toward targeted, mechanism-based interventions designed not only to induce repigmentation but also to maintain long-term disease control.
“Overall, modern vitiligo management is shifting toward targeted, mechanism-based interventions designed not only to induce repigmentation but also to maintain long-term disease control [53,54].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [54]
Conventional treatments such as topical corticosteroids and calcineurin inhibitors remain first-line in vitiligo for reducing local inflammation and halting disease progression.
“Conventional treatments such as topical corticosteroids and calcineurin inhibitors remain first-line for reducing local inflammation and halting disease progression.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [54]
Citations
Cites
Two Phase 3, Randomized, Controlled Trials of Ruxolitinib Cream for Vitiligo
Rosmarin, D. M., Passeron, T., Pandya, A. G., Grimes, P. E., Harris, J. E., Desai, S. R., Lebwohl, M., Ruer‐Mulard, M., Sénéschal, J., Wolkerstorfer, A., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2118828 · Cited by 322
Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib
Rothstein, B. E., Joshipura, D., Saraiya, A. R., Abdat, R., Ashkar, H., Turkowski, Y., Sheth, V. M., Huang, V., Au, S. C., Kachuk, C., et al. (2017) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2017.02.049 · Cited by 188
Joshipura, D., Alomran, A. M., Zancanaro, P. Q., et al. (2018) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2018.02.023 · Cited by 87
Addition of Narrow-Band UVB Phototherapy to Ruxolitinib Cream in Patients With Vitiligo
Pandya, A. G., Harris, J. E., Lebwohl, M., et al. (2022) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2022.05.1093 · Cited by 46
Hamzavi, I. H., Rosmarin, D. M., Harris, J. E., Pandya, A. G., Lebwohl, M., Gottlieb, A. B., Butler, K. A., Kuo, F. I., Sun, K., & Grimes, P. E. (2021) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2021.05.047 · Cited by 36
Harris, J. E., Pandya, A. G., Lebwohl, M., et al. (2024) · Skin Health and Disease · doi:10.1002/ski2.404 · Cited by 18
Howell, M. D., Kuo, F. I., Rumberger, B., et al. (2023) · JID Innovations · doi:10.1016/j.xjidi.2023.100230 · Cited by 8
Repigmentation by body region in patients with vitiligo treated with ruxolitinib cream over 52 weeks
Passeron, T., Harris, J. E., Pandya, A. G., et al. (2024) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.20236 · Cited by 8
Effectiveness and safety of ruxolitinib cream in Chinese patients with nonsegmental vitiligo
Huang, H., Sheng, Y., Li, M., et al. (2025) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2025.04.041 · Cited by 7
Dugourd, P.-M., Guardoli, D., Fontas, É., et al. (2025) · British Journal of Dermatology · doi:10.1093/bjd/ljaf143 · Cited by 4
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Tinca, A. C., Cozac-Szoke, A. R., & Cotoi, O. S. (2026) · Dermatopathology · doi:10.3390/dermatopathology13020022 · Cited by 1
Metadata
- Authors
- Bettolini, L., Maione, V., Carugno, A., Fratton, Z., Errichetti, E., Crivellari, M., Cartocci, A., Maronese, C. A., Venturini, M., Zerbinati, N., Rossi, M., & Bighetti, S.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- University of Insubria (IT)
- University of Udine (IT)
- University of Siena (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Corresponding author
- Bettolini, Luca
- ORCID
- Venue
- Australasian Journal of Dermatology
- Publisher
- Wiley
- Published
- 2026-03-16
- Volume
- 67
- Issue
- 4
- Pages
- e219-e225
- ISSN
- 0004-8380 (ISSN-L)
- 1440-0960
- OpenAlex
- W7138000724
- Cited by
- 3
- References
- 10
- Citations by year
- 2026: 3
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Australasian Journal of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › melanin and skin pigmentation
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Health Sciences › Medicine › Dermatology › Hair Growth and Disorders
- Keywords
- non-segmental vitiligo, repigmentation, predictors of treatment response, anatomical site, facial skin lesions, acral lesions, early clinical response, narrowband UVB, Th2 cytokines, CXCL10, biomarkers
- MeSH terms
- Janus Kinase Inhibitors, Administration, Cutaneous, Administration, Topical, Clinical Trials as Topic, Humans, Nitriles, Pyrazoles, Pyrimidines, Vitiligo, Treatment Outcome, Observational Studies as Topic
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