Pilot Study of Tildrakizumab in the Treatment of Stable Non‐Segmental Vitiligo
Henry Lee, Timothy L. Cowan, Cheng Huang, Anna Wilson, Ben Koszegi, Corey Stone, Jade Ng, Sera Sarsam, Hossein Akbarialiabad, Joslin S. Johal, Oliver G. C. Murrell, Richard A. Wittal, Dédée F. Murrell, Benjamin S. DanielABSTRACT
Background
Treatment for vitiligo is limited, with variable efficacy, and can be time‐consuming or expensive. Recent developments within biologic therapy have demonstrated promising results with managing chronic autoimmune conditions.
Objectives
To evaluate the efficacy of tildrakizumab in inducing repigmentation in vitiligo.
Methods
This was an investigator‐initiated, open label, pilot study involving a single arm of 12 patients with stable non‐segmental vitiligo. Patients were treated with once monthly subcutaneous 200 mg/mL tildrakizumab across 24 weeks. The primary outcome was change/percentage improvement in Vitiligo Area Scoring Index and Vitiligo Extent Score from baseline to Week 24.
Results
Twelve patients were enroled and eight completed the study. A nonsignificant mean percentage improvement of 1.15% in total VASI score from baseline to week 24 (95% CI, −13.77 to 16.10%, p = 0.87) and a nonsignificant mean improvement of 13.80% in VES (95% CI, −34.99 to 30.85, p = 0.89) was observed. There were no severe adverse events from the study. The most common minor adverse events recorded were upper respiratory tract infections (coryzal symptoms), erythema and hyperpigmentation.
Conclusions
Subcutaneous tildrakizumab did not demonstrate statistically significant repigmentation, however further research is warranted to explore it as an alternative option for the management of active vitiligo and as a maintenance therapy. Limitations: The study was limited due to the open‐label nature of the study, small sample size, broad inclusion criteria and selection of patients with stable, treatment‐resistant lesions.