Study Finds A Large Percentage of Vitiligo Patients Don’t Receive Treatment Within the First Year of Diagnosis

Within the first year of a patient being diagnosed with vitiligo, a large amount of them do not receive any treatment. Among those receiving treatment, most are unlikely to switch or use a combination of treatment, according to a study published in Springer Link.

Vitiligo is already a difficult-to-treat disease that is severely undertreated with only one approved treatment for repigmentation, ruxolitinib. Unfortunately, other treatment options have limitations, such as poor efficacy and side effects associated with long-term use.

Researchers of the study, which was published in August 2023, evaluated treatment patterns among vitiligo patients receiving targeted therapies within the first year of their diagnosis, as there is an absence of evidence on treatment use or treatment patterns. The vitiligo therapies include corticosteroid treatment, topical tacrolimus treatment, ultraviolet light therapy, photochemotherapy, laser therapy, excimer laser therapy and epidermal skin graft.

The retrospective cohort study included a total of 19,335 patients that were identified between October 1, 2016, and April 30, 2021, who were 12 years and older and were newly diagnosed with vitiligo. Patient eligibility consisted of one year or more of continuous enrollment before and after their vitiligo diagnosis.

Information regarding medication use, the chosen line of treatment, duration, and quantity of medication claims, as well as the length of therapy, was documented during the first year following the vitiligo diagnosis.

Data found that about 49.9% of the 19,335 patients in the analysis did not receive any treatment during their 12-month follow-up.

Treatment initiators (5,845) exhibited minimal switching, mostly opting for high-potency topical corticosteroids (25.4%), oral corticosteroids (23.1%) and topical calcineurin inhibitors (TCI, 14.7%) as first-line therapies, with older adults (486) favoring TCI (30.9%).

Those with moderate-to-severe vitiligo (3,462) were much more likely to have treatment, with only 1.5% abstaining.

Patients without prior vitiligo treatment had various times for first medication claim, ranging from 51.9 days for TCI to 178.6 days for systemic immunosuppressants.

In this study, further factors should have been examined to help better support data and understand the needs of vitiligo patients.

According to its authors, the study's limitations include missing information in the claims database, which may not comprehensively capture all vitiligo-related treatments and symptoms, excluding over-the-counter medications and self-management techniques.

As a result, this analysis is limited in its ability to fully control for differences in vitiligo severity that may affect treatment choices and outcomes.

Study findings may not focus on all individuals in the U.S. population, and experimental and investigational therapies are not captured in the claims database because insurance companies do not reimburse them.

In addition, results may be prone to bias due to non-random selection into the treatment group and commercially insured groups are represented rather than the overall population.

Though the study highlights vitiligo treatment patterns in the U.S., authors suggest future research should look deeper into demographic and clinical characteristics that are associated with the lack of receiving vitiligo treatments.