Patients with nonsegmental vitiligo see significant repigmentation with povorcitinib

Key takeaways:

• Patients with nonsegmental vitiligo taking povorcitinib saw significant repigmentation.
• The povorcitinib vs. placebo group achieved a greater Total Vitiligo Area Scoring Index baseline change (19.1% vs. –2.3%).

NEW ORLEANS — Povorcitinib was associated with substantial repigmentation in patients with extensive nonsegmental vitiligo, according to a study presented at the American Academy of Dermatology Annual Meeting.

“Vitiligo is often difficult to manage due to its progressive nature and incomplete response to treatment for most affected individuals,” Amit G. Pandya, MD, FAAD, of the University of Texas Southwestern Medical Center in Dallas, told Healio. “I’m excited about the results of this study because they showed that povorcitinib, taken as a convenient oral tablet, could be used to treat vitiligo and stop the progression of this condition.”

Pandya presented results from the double-blind, placebo-controlled, dose-ranging, phase 2b study evaluating the efficacy and safety of povorcitinib in patients with extensive vitiligo. This study is the first to report findings of the oral selective Janus kinase 1 (JAK1) inhibitor in this indication, according to Pandya.

The 171 patients aged 18 to 75 years were randomly assigned to receive povorcitinib 45 mg (n = 43), 75 mg (n = 42), 15 mg (n = 43) or placebo (n = 43) once daily for 24 weeks.

This regiment was followed by an extension period of 28 weeks where the 45 mg group continued its dosage and the other groups were assigned to povorcitinib 75 mg. The presented data reflected treatment through 36 weeks.

Efficacy assessments included a percent change in Total Vitiligo Area Scoring Index (T-VASI), which included areas of the body not exposed to the sun. According to Pandya, this is a high mark for the drug to reach as sunlight assists in the treatment of vitiligo.

Additional efficacy assessments were also a percentage of patients achieving T-VASI 50, Facial-VASI (F-VASI) 50 and F-VASI 75.

Results showed the T-VASI percentage change from baseline was statistically superior in patients treated with povorcitinib vs. placebo at week 24. Patients saw a 19.1% change with 15 mg povorcitinib, 17.8% change 45 mg and 15.7% change with 75 mg vs. a –2.3% change with placebo (P < .001 for all).

Of the povorcitinib 15 mg, 45 mg and 75 mg groups, 10.5%, 16.2% and 5.6% achieved T-VASI 50, respectively, compared with 3% of the placebo group at week 24.

Additionally, those treated with 45 mg povorcitinib showed higher efficacy in F-VASI 50 (45.5%) and F-VASI75 (18.2%) compared with the 15 mg and 75 mg doses.

All doses of povorcitinib were generally well tolerated with a favorable safety profile. A total of 13 grade 3 treatment-emergent adverse events were reported, although the researchers determined none were related to treatment.

“I am encouraged by the continued focus on expanding medical treatment options," Pandya said. "I believe these data highlight the potential of this investigational oral treatment for patients with extensive nonsegmental vitiligo.”