Key Characteristics, Treatment Patterns Identified in Patients with Vitiligo

Many individuals with vitiligo in the US remain untreated after being diagnosed, new data suggest, while patients who are treated often report short treatment durations and highly variable care patterns.1

These ongoing gaps in standardized management strategies for vitiligo were highlighted in a recent analysis published in JAMA. Investigators, led by Roni Adiri, PhD, of Pfizer Pharmaceutical Israel LTD, conducted this recent retrospective cohort analysis to explore the demographic and clinical characteristics of those living with vitiligo, as well as how approaches to therapy differ according to age and disease extent.

“Leveraging linked electronic health records (EHRs) and claims data in the US, this study characterizes demographics, clinical characteristics, and treatment patterns in patients with vitiligo, overall and by vitiligo extent and age,” Adiri and colleagues wrote.1

The analysis used de-identified data drawn from the linked Komodo Healthcare Map and OMNY Health Foundation databases. These databases combine electronic health record information with medical and pharmacy claims from US dermatology clinics and broader health care settings across the country.

How Was the Study Designed?

Adiri et al identified individuals whose first documented vitiligo diagnosis took place in the timeframe between January 2018 - August 2023. Those involved as subjects were required to have at least a single year of continuous health plan enrollment prior to their index diagnosis date. Otherwise, they needed an equivalent eligibility proxy in the case of open claims data, along with 3 months at least of follow-up after diagnosis.

Participants without age information or follow-up data were not included. Those included in Adiri and coauthors’ analysis were categorized based on their age and the percentage of body surface area (BSA) impacted by vitiligo at the point of baseline. They grouped patients’ disease extent into involvement of 10% BSA or less, over 10% BSA, or no documented BSA evaluation at index. Their data analysis was carried out between April - August 2024.

Which Patterns Were Identified in Patients with Vitiligo?

The final study population included 24,949 individuals with vitiligo. However, only 5.3% of the cohort were shown to have a documented BSA assessment at the time of their diagnosis. Among subjects with recorded disease extent, 963 of these patients showed 10% or less BSA involvement. 366 were noted to have more extensive disease affecting over 10% BSA.

88.2% those included in the cohort were adults aged 18 years or older and 56.3% were female. Among those with available data regarding lesion location, facial involvement was the most commonly reported manifestation, appearing in roughly one-third of observed cases. Although there are chronic and often psychosocial burdens linked vitiligo, a notable proportion of those assessed did not receive treatment during their follow-up interactions.2 Depending on BSA subgroup, Adiri and colleagues noted between 27% - 32% of patients remained untreated following their diagnosis.

The investigators also observed the highest untreated proportion to be participants showing limited disease involvement. Among the individuals who did receive treatment, topical and systemic corticosteroids represented some of the most frequently utilized agents. Topical calcineurin inhibitors and phosphodiesterase-4 (PDE4) inhibitors were also commonly prescribed. The team further noted the similarity between treatment patterns, regardless of disease extent, with few meaningful distinctions noted between BSA categories.

However, Adiri et al did find age-related differences in management. Children and adolescents were found to be more likely to receive topical drugs, whereas adults more commonly received systemic medications. The investigative team additionally found considerable heterogeneity in sequencing of treatments for vitiligo, suggesting a lack of consistent therapeutic pathways in routine practice settings.

Treatment persistence also appeared limited. Adiri and coauthors described median duration of therapy as ranging from approximately 1.8 months to 4.1 months across first- and second-line treatment regimens. This depended on the therapeutic modality implemented.

What Can We Conclude About Vitiligo in the US?

Overall, the investigators’ data point to significant variability in the way vitiligo is managed in clinical practice and suggest many individuals with vitiligo may not be receiving sustained or standardized care. In the team’s conclusion, these real-world insights were described as helping to guide future research efforts and inform strategies designed to improve outcomes for those living with vitiligo.

References

1. Adiri R, Gauthier G, Kurosky SK, et al. Clinical Characteristics and Treatment Patterns in Patients With Vitiligo. JAMA Dermatol. Published online May 06, 2026. doi:10.1001/jamadermatol.2026.0971.

2. Seneschal J, Speeckaert R, van Geel N, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the international Vitiligo Task Force-Part 2: Specific treatment recommendations. J Eur Acad Dermatol Venereol. 2023 Nov;37(11):2185-2195. doi: 10.1111/jdv.19450. Epub 2023 Sep 15. PMID: 37715487.