A review of JAK and IL‐23 inhibitors to treat vitiligo

Abstract

Vitiligo is an autoimmune skin disorder resulting in the depigmentation of skin characterised by patches of varying sizes and shapes. A common disorder of pigmentation that affects 0.5%–2% of the global population. Despite its well‐understood autoimmune pathogenesis, the targets for effective cytokine intervention remain unclear. Current first‐line treatments include oral or topical corticosteroids, calcineurin inhibitors and phototherapy. These treatments are limited, have varying efficacies, and are associated with significant adverse events or can be time‐consuming. Therefore, biologics should be explored as a potential treatment for vitiligo. There are currently limited data for the use of JAK and IL‐23 inhibitors for vitiligo. A total of 25 studies were identified in the review. There is promising evidence regarding the use of JAK and IL‐23 inhibitors for the treatment of vitiligo.

Guselkumab-induced vitiligo in a patient with psoriatic arthritis

“…A few reports of vitiligo onset during anti-IL-17 treatment (ixekizumab or secukinumab) were reported, and in none of these cases, the biologic drug was interrupted. 5 , 6 , 7 , 8 …”

“…Recently, Lee et al 8 reviewed the literature regarding the use of Janus kinase inhibitors and anti-IL-23 in the treatment of vitiligo.…”

“…Regarding the use of anti-IL-23, several studies have reported an increase of IL-23 levels in patients with vitiligo; therefore, the authors concluded that considering the established documentation of IL-23 elevation in patients with vitiligo, targeted treatment should be considered as a potential novel therapy. 8 …”

“…IL-23 is an important cytokine in autoimmunity, promoting Th17 cell differentiation and causing an inflammatory response, leading to the production of neutrophils; therefore, the authors concluded that the role of these drugs in the treatment of vitiligo could be considered. 8 …”